Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05083 | Date 24/11/2021 |
| Token No | SM/21-22/1463 24/11/2021 | Serial | 012 |
| Patient Name | Mrs. MANJUSHREE KUNDU | Contact No | 9903862882 |
| Address | 25/A G T ROAD, MADAM BAGAN | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||