Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06626 | Date 25/04/2024 |
| Token No | SM/24-25/21149 25/04/2024 | Serial | 024 |
| Patient Name | Mrs. JYOTI SHAW | Contact No | 6290651643 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||