Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07366 | Date 21/10/2022 |
| Token No | SM/24-25/16342 17/05/2024 | Serial | 012 |
| Patient Name | Mrs. DURGA DEBI KUSWA | Contact No | 8057803117 |
| Address | NEAR TELEPHONE EXCHANGE | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||