Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 04038 | Date 10/04/2023 |
| Token No | SM/22-23/8110 10/04/2023 | Serial | 044 |
| Patient Name | Mrs. REHENA BIBI | Contact No | 9330831588 |
| Address | 20 KANAI DEWANTALA BYE LANE CHATRA SERAMPORE 712223 | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||