Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07394 | Date 25/10/2022 |
| Token No | SM/22-23/5791 25/10/2022 | Serial | 019 |
| Patient Name | Mrs. SOMA SHA | Contact No | NOT GIVEN |
| Address | 79B DEY STREET | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||