Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01780 | Date 10/03/2019 |
| Token No | SM/22-23/8300 15/03/2023 | Serial | 001 |
| Patient Name | Mrs. DOLI BEGUM | Contact No | 7890565382 |
| Address | K C BHATTACHARYA STREET | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||