Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05247 | Date 26/09/2023 |
| Token No | SM/22-23/13563 26/09/2023 | Serial | 030 |
| Patient Name | Mr. SK RAFIK | Contact No | 6290654757 |
| Address | 88 MIYAJAN DARJI LANE MALLICK[PARA SERAMPORE 712203 | Age | 34 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 67 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||