Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03383 | Date 12/12/2022 |
| Token No | SM/22-23/5345 15/12/2022 | Serial | 035 |
| Patient Name | Mrs. SHIPRA GHOSH | Contact No | 9836546455 |
| Address | 65/A/34 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 52 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||