Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03998 | Date 30/03/2023 |
| Token No | SM/22-23/7898 30/03/2023 | Serial | 013 |
| Patient Name | Mrs. KABITA CHAKRABORTY | Contact No | 8583025289 |
| Address | 2/207 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||