Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05759 | Date 25/04/2022 |
| Token No | SM/22-23/2816 25/04/2022 | Serial | 014 |
| Patient Name | Mrs. SHETA ROY | Contact No | 9073063619 |
| Address | 7 KENAS LANE | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||