Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05294 | Date 29/09/2023 |
| Token No | SM/22-23/13748 29/09/2023 | Serial | 045 |
| Patient Name | Mr. JIBAN KRISHNA DEBNATH | Contact No | 9875470959 |
| Address | VIDYASAGAR PALLY SHEORAPHULI 712223 | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||