Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03372 | Date 10/12/2022 |
| Token No | SM/22-23/5170 10/12/2022 | Serial | 001 |
| Patient Name | Mrs. DOLI MOLLA | Contact No | |
| Address | 59/C MALLICKPARA SERAMPORE 712203 | Age | 50 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 61 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||