Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13819 | Date 03/12/2025 |
| Token No | SM/25-26/2859 03/12/2025 | Serial | 008 |
| Patient Name | Mrs. PADMABATI ROY | Contact No | 6392581910 |
| Address | NEAR SMASAN KALI | Age | 58 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||