Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05765 | Date 26/04/2022 |
| Token No | SM/22-23/2828 26/04/2022 | Serial | 007 |
| Patient Name | Mrs. SHANKARI DAS | Contact No | NOT GIVEN |
| Address | BANERJEE PARA | Age | 66 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||