Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04199 | Date 18/05/2023 |
| Token No | SM/22-23/8954 18/05/2023 | Serial | 039 |
| Patient Name | Mrs. SAMITA CHAKRABORTY | Contact No | |
| Address | 65/25/31 PRABASHNAGAR SERAMPORE 712249 | Age | 48 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||