Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05878 | Date 15/12/2023 |
| Token No | SM/22-23/16551 15/12/2023 | Serial | 005 |
| Patient Name | Mr. RABI POLLEY | Contact No | 8961164534 |
| Address | 10 DR B R AMBEDKAR LANE SERAMPORE 712203 | Age | 52 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 54 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||