Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04184 | Date 15/05/2023 |
| Token No | SM/22-23/8852 15/05/2023 | Serial | 029 |
| Patient Name | Mrs. FULMATI SAHANI | Contact No | 8276064139 |
| Address | 9/437/A/B G G ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 36 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||