Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03623 | Date 19/01/2023 |
| Token No | SM/22-23/6177 19/01/2023 | Serial | 019 |
| Patient Name | Mrs. MALA ROYCHOWDHURY | Contact No | |
| Address | 97/H/1 PRABASHNAGAR SERAMPORE 712249 | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||