Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05855 | Date 13/12/2023 |
| Token No | SM/22-23/16442 13/12/2023 | Serial | 021 |
| Patient Name | Mrs. MAMANI UPADHYAY | Contact No | 6290980507 |
| Address | 15/32/B/N GODAR BAGAN BYE LANE CHATRA BAIDYABATI M 712204 | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 57 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||