Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03299 | Date 01/12/2022 |
| Token No | SM/22-23/4922 01/12/2022 | Serial | 004 |
| Patient Name | Mrs. JAHEDA BIBI | Contact No | 7439998764 |
| Address | 23/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 60 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||