Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02113 | Date 30/06/2022 |
| Token No | SM/22-23/1031 30/06/2022 | Serial | 045 |
| Patient Name | Mr. MANOWARA BEGAM | Contact No | 8296499552 |
| Address | 36/4 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 47 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 85 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||