Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02078 | Date 17/05/2019 |
| Token No | SM/21-22/332 02/06/2021 | Serial | 004 |
| Patient Name | Miss SUTITHI CHATTOPADHAYA | Contact No | 9331926312 |
| Address | 502 B G T ROAD | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||