Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04903 | Date 13/09/2021 |
| Token No | SM/22-23/2720 19/04/2022 | Serial | 011 |
| Patient Name | Mrs. TAMASHA GORAI | Contact No | 7890986500 |
| Address | 8/D DEY STREET | Age | 43 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||