Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04233 | Date 27/05/2023 |
| Token No | SM/22-23/9115 27/05/2023 | Serial | 002 |
| Patient Name | Mrs. MANJU DEVI SHAW | Contact No | 9062707774 |
| Address | SUKANTA PALLY SERAMPORE 712203 | Age | 35 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||