Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08350 | Date 16/02/2023 |
| Token No | SM/25-26/580 24/05/2025 | Serial | 040 |
| Patient Name | Mrs. SHYAMALI KARMAKAR | Contact No | 6289622884 |
| Address | 33 R B SARANI | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||