Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 11068 | Date 25/01/2024 |
| Token No | SM/22-23/14423 25/01/2024 | Serial | 021 |
| Patient Name | Mrs. SIBANI SHAW | Contact No | |
| Address | 81 J.N. LAHIRI ROAD | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||