Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09460 | Date 22/06/2023 |
| Token No | SM/24-25/16538 29/05/2024 | Serial | 005 |
| Patient Name | Mrs. KAJAL SIMLAI | Contact No | 9432120309 |
| Address | 35/A SASHIBHUSAN GHOSH LANE | Age | 64 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||