Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04237 | Date 05/04/2021 |
| Token No | SM/22-23/14368 19/01/2024 | Serial | 004 |
| Patient Name | Mrs. LATIKA ADHIKARI | Contact No | NOT GIVEN |
| Address | 18/A BROJO DUTTA LANE | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||