Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 06229 | Date 09/02/2024 |
| Token No | SM/22-23/18429 09/02/2024 | Serial | 060 |
| Patient Name | Mr. MD RAFIQUE ANSARI | Contact No | 6290811373 |
| Address | 26 MIAJAN DORJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 32 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||