Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02778 | Date 24/09/2022 |
| Token No | SM/22-23/3021 24/09/2022 | Serial | 030 |
| Patient Name | Mr. RAJAN KUMAR SRIBASTAVA | Contact No | 9748036975 |
| Address | 1 HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 32 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||