Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05610 | Date 31/03/2022 |
| Token No | SM/21-22/2559 31/03/2022 | Serial | 014 |
| Patient Name | Mrs. MOHORJAN BEGUM | Contact No | 7436002803 |
| Address | 41 K M BHATTACHARJEE STREET | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||