Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 02956 | Date 21/10/2022 |
| Token No | SM/22-23/3683 21/10/2022 | Serial | 015 |
| Patient Name | Mr. RON MAJHI | Contact No | 9874402055 |
| Address | 71/A J N LAHIRI ROAD SERAMPORE 712201 | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||