Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01785 | Date 01/06/2022 |
| Token No | SM/22-23/282 01/06/2022 | Serial | 010 |
| Patient Name | Mr. MOHAMMAD AKTAR | Contact No | |
| Address | 26 MIYAJAN DARJEE LANE MALLICKPARA SERAMPORE 712203 | Age | 50 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 74 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||