Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10815 | Date 23/11/2023 |
| Token No | SM/22-23/13371 23/11/2023 | Serial | 012 |
| Patient Name | Mrs. KALIDASI MONDAL | Contact No | 9123691742 |
| Address | 39B SASHIBHUSAN GHOSH LANE | Age | 69 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||