Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02008 | Date 23/06/2022 |
| Token No | SM/22-23/754 23/06/2022 | Serial | 003 |
| Patient Name | Mrs. NIKITA SINGH | Contact No | 8017539602 |
| Address | ADARSHA PALLY SERAMPORE MALLICKPARA 712203 | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||