Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03511 | Date 28/12/2022 |
| Token No | SM/22-23/5698 28/12/2022 | Serial | 016 |
| Patient Name | Mrs. RENUKA DAS | Contact No | 9874143578 |
| Address | 3 DCRUZE GARDEN LANE MALLICKPARA SERAMPORE 712203 | Age | 47 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||