Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02367 | Date 01/08/2022 |
| Token No | SM/22-23/1757 01/08/2022 | Serial | 037 |
| Patient Name | Mr. AKHIL BARUI | Contact No | 8420469266 |
| Address | 22A MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 55 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||