Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02746 | Date 22/09/2022 |
| Token No | SM/22-23/6082 13/01/2023 | Serial | 035 |
| Patient Name | Mrs. SUMITA HALDER SEULY | Contact No | 7439050833 |
| Address | 4/A/2/A TARAPUKUR BAGAN BASTI LANE SERAMPORE 712203 | Age | 48 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||