Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04222 | Date 26/05/2023 |
| Token No | SM/22-23/9092 26/05/2023 | Serial | 014 |
| Patient Name | Mrs. FULMANTI DEVI | Contact No | 9339665063 |
| Address | CHAKLAPARA PRABASHNAGAR SERAMPORE 712249 | Age | 41 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||