Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10649 | Date 05/10/2023 |
| Token No | SM/22-23/13886 18/12/2023 | Serial | 037 |
| Patient Name | Mrs. GOURI SHAW | Contact No | 9748057889 |
| Address | 41/A BHAGIRATHI LANE | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||