Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02339 | Date 29/07/2022 |
| Token No | SM/22-23/5347 15/12/2022 | Serial | 037 |
| Patient Name | Miss DOLAN BANIK | Contact No | 9330502649 |
| Address | 24/D TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||