Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04678 | Date 04/08/2021 |
| Token No | SM/21-22/763 04/08/2021 | Serial | 002 |
| Patient Name | Mrs. PUJA BHADRA | Contact No | 9883479900 |
| Address | CHATRA LANKAR BAGAN | Age | 25 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||