Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03524 | Date 29/12/2022 |
| Token No | SM/22-23/5733 29/12/2022 | Serial | 004 |
| Patient Name | Mrs. SHANTIDEBI SHAW | Contact No | 7439250996 |
| Address | 79 NEW MAHESH SERAMPORE 712203 | Age | 63 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||