Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01701 | Date 27/05/2022 |
| Token No | SM/22-23/654 21/06/2022 | Serial | 002 |
| Patient Name | Mrs. SADHANA SADHUKHAN | Contact No | 9330633656 |
| Address | 26 SANIPARA LANE SERAMPORE 712203 | Age | 62 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||