Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05749 | Date 28/11/2023 |
| Token No | SM/22-23/15879 28/11/2023 | Serial | 016 |
| Patient Name | Miss KHUSI DOLUI | Contact No | 9007115241 |
| Address | KAJIPARA BAIDYABATI HOOGHLY 712222 | Age | 23 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||