Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11544 | Date 16/05/2024 |
| Token No | SM/24-25/21292 12/03/2025 | Serial | 008 |
| Patient Name | Mrs. SUSMITA KOLEY | Contact No | 7596858355 |
| Address | 16/16/1 DEY STREET | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||