Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 03442 | Date 19/12/2022 |
| Token No | SM/22-23/5655 27/12/2022 | Serial | 013 |
| Patient Name | Mrs. LAKSHMIRANI GHOSH | Contact No | 9163356551 |
| Address | 18/C SANIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 66 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||