Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06671 | Date 08/08/2022 |
| Token No | SM/22-23/4400 08/08/2022 | Serial | 026 |
| Patient Name | Mrs. SUKLA DAS | Contact No | NOT GIVEN |
| Address | PITAMBAR DEY LANE | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||