Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03166 | Date 17/11/2022 |
| Token No | SM/22-23/4481 17/11/2022 | Serial | 004 |
| Patient Name | Mr. ASIT CHAKRABORTY | Contact No | 8276879114 |
| Address | GHORAMARA P MALLICKPARA SERAMPORE 712203 | Age | 51 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||