Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05376 | Date 09/10/2023 |
| Token No | SM/22-23/14147 09/10/2023 | Serial | 067 |
| Patient Name | Mr. UMAR FAROOQ | Contact No | 8100587927 |
| Address | 88C MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 11 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 24 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||