Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 03172 | Date 17/11/2022 |
| Token No | SM/22-23/9140 27/05/2023 | Serial | 027 |
| Patient Name | Mrs. SUSHILA DEVI | Contact No | |
| Address | 1 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 80 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||