Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03311 | Date 05/12/2022 |
| Token No | SM/22-23/4950 05/12/2022 | Serial | 004 |
| Patient Name | Mrs. JUTHIKA GANGULY | Contact No | 9143628380 |
| Address | 163/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||