Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03660 | Date 28/01/2023 |
| Token No | SM/22-23/6323 28/01/2023 | Serial | 029 |
| Patient Name | Mrs. SUNITA CHOUDHURI | Contact No | |
| Address | 29/C PRABASHNAGAR SERAMPORE 712249 | Age | 36 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||