Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04250 | Date 29/05/2023 |
| Token No | SM/22-23/9178 29/05/2023 | Serial | 029 |
| Patient Name | Mrs. CHHAYA SING | Contact No | 7890556903 |
| Address | GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 51 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||