Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04300 | Date 10/06/2023 |
| Token No | SM/22-23/9441 10/06/2023 | Serial | 010 |
| Patient Name | Mrs. SWAPNA DEBNATH | Contact No | 7688016027 |
| Address | 22/Y/21 F D ROAD MALLICKPARA SERAMPORE 712203 | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||