Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03566 | Date 03/01/2023 |
| Token No | SM/22-23/5970 07/01/2023 | Serial | 013 |
| Patient Name | Mrs. SABARI GHOSH HALDER | Contact No | 8697782230 |
| Address | 66/L F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||