Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02120 | Date 04/07/2022 |
| Token No | SM/24-25/25820 31/07/2024 | Serial | 042 |
| Patient Name | Mrs. SOMA PODDAR DAS | Contact No | 9836971577 |
| Address | 5 NO COLONY DAKSHIN RAJYADHARPUR MALLICKPARA 712203 | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||