Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03536 | Date 30/12/2022 |
| Token No | SM/22-23/5797 30/12/2022 | Serial | 029 |
| Patient Name | Mr. SK ROMJAN ALI | Contact No | 7685044192 |
| Address | 18/A MIA JAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 22 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||