Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04025 | Date 08/04/2023 |
| Token No | SM/22-23/8054 08/04/2023 | Serial | 017 |
| Patient Name | Miss ROSHANI PANDIT | Contact No | 7890956362 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||