Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03358 | Date 08/12/2022 |
| Token No | SM/22-23/5112 08/12/2022 | Serial | 038 |
| Patient Name | Mr. SHIBANI DAS | Contact No | 9748055227 |
| Address | 1/A SASHIBHUSAN GHOSH LANE SERAMPORE MAHESH 1 712202 | Age | 49 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||