Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03658 | Date 28/01/2023 |
| Token No | SM/22-23/6518 02/02/2023 | Serial | 041 |
| Patient Name | Mrs. NIVA SRIVASTAB | Contact No | |
| Address | SERAMPORE | Age | 47 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||