Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 03789 | Date 17/02/2023 |
| Token No | SM/22-23/8211 13/04/2023 | Serial | 028 |
| Patient Name | Mrs. MINA DEBI | Contact No | 9330281220 |
| Address | 56 RAYLAND ROAD SERAMPORE 712201 | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||