Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05254 | Date 26/09/2023 |
| Token No | SM/22-23/13651 27/09/2023 | Serial | 058 |
| Patient Name | Mr. SK SUKUR | Contact No | |
| Address | 32 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 42 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 43 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||