Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04009 | Date 05/04/2023 |
| Token No | SM/22-23/9467 10/06/2023 | Serial | 036 |
| Patient Name | Mrs. JHUMPA DAS | Contact No | 8646868400 |
| Address | 43/18/B GURUGARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||