Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05538 | Date 15/03/2022 |
| Token No | SM/21-22/2428 15/03/2022 | Serial | 006 |
| Patient Name | Mrs. RUMA MONDAL | Contact No | NOT GIVEN |
| Address | BIBIR BER SERAMPORE | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||