Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 07255 | Date 14/10/2022 |
| Token No | SM/22-23/12470 14/09/2023 | Serial | 010 |
| Patient Name | Mrs. DIPALI BAIRAGI | Contact No | NOT GIVEN |
| Address | 17/A GANGULY BAGAN | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||