Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04197 | Date 18/05/2023 |
| Token No | SM/22-23/8951 18/05/2023 | Serial | 036 |
| Patient Name | Mrs. JYOTSNA SAMANTA | Contact No | 8583046503 |
| Address | 24/K F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 75 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||