Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03612 | Date 16/01/2023 |
| Token No | SM/22-23/6124 16/01/2023 | Serial | 015 |
| Patient Name | Mr. ABDUL MOMEN MALLICK | Contact No | 8653411173 |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 19 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 58 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||