Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12068 | Date 06/09/2024 |
| Token No | SM/24-25/19532 30/10/2024 | Serial | 025 |
| Patient Name | Mrs. SELI ROY | Contact No | 8017547588 |
| Address | 45 PANCHANANTALA LANE | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||