Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 07133 | Date 26/09/2022 |
| Token No | SM/22-23/10681 06/07/2023 | Serial | 003 |
| Patient Name | Mrs. JOLY DEY | Contact No | 7449781648 |
| Address | 41 N N COLONY | Age | 38 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||