Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02509 | Date 22/08/2022 |
| Token No | SM/22-23/2169 22/08/2022 | Serial | 023 |
| Patient Name | Mr. MONU MALLICK | Contact No | |
| Address | 15 MALLICKPARA SERAMPORE 712203 | Age | 65 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||