Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04101 | Date 27/04/2023 |
| Token No | SM/22-23/9603 15/06/2023 | Serial | 016 |
| Patient Name | Mrs. MOUSUMI DAS | Contact No | 9830563756 |
| Address | 244/2 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||