Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05253 | Date 07/01/2022 |
| Token No | SM/22-23/8397 20/03/2023 | Serial | 012 |
| Patient Name | Mrs. SUMANA DEY | Contact No | 9830363864 |
| Address | 1 DEY STREET | Age | 28YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||