Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09662 | Date 18/07/2023 |
| Token No | SM/22-23/10969 18/07/2023 | Serial | 003 |
| Patient Name | Mrs. GITA ROY | Contact No | 7044108402 |
| Address | 3 PITAMBAR DEY LANE | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||