Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 11343 | Date 01/04/2024 |
| Token No | SM/24-25/17742 26/07/2024 | Serial | 002 |
| Patient Name | Mrs. MONGALA KARMAKAR | Contact No | 9051711713 |
| Address | 58 DHULIPARA LANE | Age | 58 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||