Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04269 | Date 02/06/2023 |
| Token No | SM/22-23/9311 05/06/2023 | Serial | 012 |
| Patient Name | Mrs. SHILA KARMAKR | Contact No | 8420706296 |
| Address | 65/A/14 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 53 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||