Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 09434 | Date 21/06/2023 |
| Token No | SM/22-23/11214 26/07/2023 | Serial | 012 |
| Patient Name | Mrs. SHRAMANA DUTTA JANA | Contact No | 798089215 |
| Address | 73/27 J.N. LAHIRI ROAD | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||