Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05616 | Date 31/03/2022 |
| Token No | SM/21-22/2565 31/03/2022 | Serial | 020 |
| Patient Name | Mrs. JAYETA BHATTACHARJEE | Contact No | 9339164019 |
| Address | 61 R B SARANI | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||