Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01866 | Date 10/06/2022 |
| Token No | SM/22-23/5725 28/12/2022 | Serial | 043 |
| Patient Name | Mrs. PURNIMA DAS | Contact No | 8697141327 |
| Address | B/110/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 37 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||