Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03512 | Date 28/12/2022 |
| Token No | SM/22-23/5700 28/12/2022 | Serial | 018 |
| Patient Name | Miss DIPIKA BAG | Contact No | 9088082011 |
| Address | 13 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 6 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||