Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03050 | Date 04/11/2022 |
| Token No | SM/22-23/4037 04/11/2022 | Serial | 001 |
| Patient Name | Mr. BISWAJIT PAUL | Contact No | 8961167671 |
| Address | 22/24/1/A FIRINGI DANGA ROAD MALLICKPARA SERAMPORE 712203 | Age | 46 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 63 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||