Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00378 | Date 15/11/2019 |
| Token No | SM/22-23/6901 17/02/2023 | Serial | 013 |
| Patient Name | Mrs. JYOTSNA DAS | Contact No | 9088516793 |
| Address | 43/15/C PRABASHNAGAR SERAMPORE 712203 | Age | 73 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||