Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02839 | Date 30/09/2022 |
| Token No | SM/22-23/6090 14/01/2023 | Serial | 007 |
| Patient Name | Mrs. RUPA GHORUI | Contact No | 7044492171 |
| Address | B B GHOSH ROAD MALLICKPARA SERAMPORE 712203 | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||