Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03236 | Date 24/11/2022 |
| Token No | SM/22-23/6591 06/02/2023 | Serial | 021 |
| Patient Name | Mrs. GOURI MALAKAR | Contact No | 7685069899 |
| Address | 34/B/27 B B GHOSH ROAD SUKANTA PALLY SERAMPORE 712203 | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||