Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01247 | Date 20/03/2020 |
| Token No | SM/22-23/6354 30/01/2023 | Serial | 018 |
| Patient Name | Mrs. SANTANA SIULY | Contact No | 9231552763 |
| Address | 5/A TARAPUKUR COLONY SERAMPORE 712203 | Age | 57 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||