Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03466 | Date 22/12/2022 |
| Token No | SM/22-23/5904 03/01/2023 | Serial | 037 |
| Patient Name | Mrs. SUMAN SHAW | Contact No | 9330556001 |
| Address | 118/2 L.N ATTA ROAD CHAPDANI SERAMPORE | Age | 22 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||