Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03802 | Date 05/02/2020 |
| Token No | SM/22-23/5391 10/10/2022 | Serial | 024 |
| Patient Name | Mrs. CHAMPA DEVI | Contact No | 9117669972 |
| Address | 22/1 N L BHATTACHARJEE STREET | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||