Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02872 | Date 13/10/2022 |
| Token No | SM/22-23/6900 17/02/2023 | Serial | 012 |
| Patient Name | Mrs. PURNIMA DEBI DAS | Contact No | 9748685695 |
| Address | 55 ROYLAND ROAD SERAMPORE 712201 | Age | 62 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||