Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02159 | Date 06/07/2022 |
| Token No | SM/22-23/7451 11/03/2023 | Serial | 013 |
| Patient Name | Mrs. MOHARANI TALUKDAR | Contact No | 8777868648 |
| Address | 24H FIRINGI DANGA ROAD MALLICKPARA SERAMPORE 712203 | Age | 88 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||