Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04900 | Date 08/09/2021 |
| Token No | SM/22-23/7737 07/02/2023 | Serial | 032 |
| Patient Name | Mrs. PUSPANJALI SAHU | Contact No | 8478087470 |
| Address | 18/97 DR. N. L. BHATTACHARYA STREET | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||