Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04094 | Date 25/04/2023 |
| Token No | SM/22-23/9027 22/05/2023 | Serial | 020 |
| Patient Name | Mrs. KOUSALIYA DEVI | Contact No | 6290728216 |
| Address | 1/D/2/A/1 K M GOSWAMI SARANI SERAMPORE 712202 | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||