Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01762 | Date 30/05/2022 |
| Token No | SM/22-23/9218 01/06/2023 | Serial | 002 |
| Patient Name | Mrs. DOLI DAS | Contact No | 8274034809 |
| Address | 38E B B GHOSH ROAD SERAMPORE 712203 | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||