Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11153 | Date 20/02/2024 |
| Token No | SM/22-23/14795 20/02/2024 | Serial | 004 |
| Patient Name | Mrs. CHHABI DUTTA | Contact No | NOT GIVEN |
| Address | 3A BAISNAB PARA LANE | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||