Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02756 | Date 23/09/2022 |
| Token No | SM/22-23/5459 20/12/2022 | Serial | 005 |
| Patient Name | Mrs. BHANUMATI GHOSH | Contact No | |
| Address | 65/2 PROVASNAGAR SRAMPORE 712249 | Age | 92 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||