Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01618 | Date 23/05/2022 |
| Token No | SM/22-23/5573 23/12/2022 | Serial | 010 |
| Patient Name | Mrs. RAJ KUMARI ROUTH | Contact No | 8276070933 |
| Address | 9/433 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 60 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||