Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 03400 | Date 14/12/2022 |
| Token No | SM/22-23/5294 14/12/2022 | Serial | 040 |
| Patient Name | Mrs. KUNTI DEBI | Contact No | 6290958905 |
| Address | 10/B HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 59 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||