Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10908 | Date 09/12/2023 |
| Token No | SM/22-23/13644 09/12/2023 | Serial | 004 |
| Patient Name | Mrs. SUKLA BANERJEE | Contact No | NOT GIVEN |
| Address | 37 G.T. ROAD | Age | 58 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||