Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 11358 | Date 03/04/2024 |
| Token No | SM/24-25/15578 03/04/2024 | Serial | 004 |
| Patient Name | Mrs. LILI CHAKRABORTY | Contact No | |
| Address | 129 N.N. COLONY | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||