Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04645 | Date 22/07/2021 |
| Token No | SM/24-25/15720 15/04/2024 | Serial | 001 |
| Patient Name | Mrs. PIPASA DAS | Contact No | 7439256151 |
| Address | 552/A G T ROAD | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||