Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05336 | Date 21/01/2022 |
| Token No | SM/21-22/1973 21/01/2022 | Serial | 008 |
| Patient Name | Mrs. SABITRI DEY | Contact No | NOT GIVEN |
| Address | 13 DHARMATALA | Age | 63 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||