Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01633 | Date 23/05/2022 |
| Token No | SM/22-23/55 23/05/2022 | Serial | 024 |
| Patient Name | Mrs. SITA SHAW | Contact No | 8478819210 |
| Address | 6 NO HUMAR PATTY LANE SERAMPORE | Age | 43 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 64 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||