Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02680 | Date 09/09/2022 |
| Token No | SM/22-23/5960 07/01/2023 | Serial | 003 |
| Patient Name | Mrs. CHADNI KUMARI RABIDAS | Contact No | 9748384063 |
| Address | 66/A/4 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 35 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||