Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04395 | Date 18/05/2021 |
| Token No | SM/22-23/14484 31/01/2024 | Serial | 003 |
| Patient Name | Mrs. RUMA DEY | Contact No | NOT GIVEN |
| Address | 140 G T ROAD, MANIKTALA | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||