Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03562 | Date 03/01/2023 |
| Token No | SM/22-23/5898 03/01/2023 | Serial | 031 |
| Patient Name | Mrs. RAFAT PARVEEN | Contact No | |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||