Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04494 | Date 13/07/2023 |
| Token No | SM/22-23/10466 13/07/2023 | Serial | 005 |
| Patient Name | Mr. RABI MALLICK | Contact No | 8335956547 |
| Address | 26/A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 42 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||