Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02666 | Date 09/09/2022 |
| Token No | SM/22-23/7605 16/03/2023 | Serial | 030 |
| Patient Name | Mrs. ASHA KUMARI DEVI | Contact No | 8276969135 |
| Address | 97/P/5 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||