Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02290 | Date 20/07/2022 |
| Token No | SM/22-23/11012 26/07/2023 | Serial | 056 |
| Patient Name | Mr. SK ASIF | Contact No | 9051778242 |
| Address | 9 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 19 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||