Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01789 | Date 01/06/2022 |
| Token No | SM/22-23/739 22/06/2022 | Serial | 039 |
| Patient Name | Mrs. ANAMIKA CHAKRABORTY | Contact No | 8443815898 |
| Address | 56/A/7 MALLICKPARA LANE SERAMPORE 712203 | Age | 31 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||