Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 07106 | Date 22/09/2022 |
| Token No | SM/22-23/5260 22/09/2022 | Serial | 007 |
| Patient Name | Mrs. SARALA CHOWDHURY | Contact No | NOT GIVEN |
| Address | 15 LBS ROAD | Age | 70 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||