Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07626 | Date 14/11/2022 |
| Token No | SM/22-23/14173 08/01/2024 | Serial | 037 |
| Patient Name | Miss RAI SARKAR | Contact No | 8777465506 |
| Address | 42 POTUA PARA | Age | 16 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||