Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10731 | Date 03/11/2023 |
| Token No | SM/24-25/18926 23/09/2024 | Serial | 005 |
| Patient Name | Miss DAMINI DOM | Contact No | 7044074422 |
| Address | 77 THAKURBATI STREET | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||