Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03509 | Date 28/12/2022 |
| Token No | SM/22-23/5695 28/12/2022 | Serial | 013 |
| Patient Name | Mrs. MOUSUMI KARMAKAR | Contact No | 9051869195 |
| Address | 30/40 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 70 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||