Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 00859 | Date 04/02/2020 |
| Token No | SM/22-23/9748 19/06/2023 | Serial | 040 |
| Patient Name | Mrs. LATIKA ADAK | Contact No | 8961046779 |
| Address | 59A/1 MALLIKPARA LANE SERAMPORE 712203 | Age | 66 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||