Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03916 | Date 13/03/2023 |
| Token No | SM/22-23/8217 13/04/2023 | Serial | 034 |
| Patient Name | Mrs. RENU ROY DEBSARMA | Contact No | 9804340244 |
| Address | 20/B/A PROVASNAGAR SERAMPORE 712249 | Age | 28 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||