Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02869 | Date 12/10/2022 |
| Token No | SM/22-23/5402 17/12/2022 | Serial | 035 |
| Patient Name | Mrs. MOUMITA DAS | Contact No | 8777418731 |
| Address | 30/19 RATHIN PAL SARANI RISHRA M 712250 | Age | 25 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||