Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03385 | Date 12/12/2022 |
| Token No | SM/22-23/5229 12/12/2022 | Serial | 040 |
| Patient Name | Mrs. MAMONI DAS | Contact No | 6290980507 |
| Address | 15/32/B/N GODAR BAGAN BYE LANE BAIDYABATI M 712204 | Age | 24 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 53 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||