Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01623 | Date 23/05/2022 |
| Token No | SM/22-23/7249 04/03/2023 | Serial | 004 |
| Patient Name | Mrs. SAILO DAS | Contact No | 9434837879 |
| Address | 10J HARIPARA LANE SERAMPORE 712203 | Age | 82 YRS Other |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||