Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01966 | Date 21/06/2022 |
| Token No | SM/22-23/660 21/06/2022 | Serial | 008 |
| Patient Name | Mr. KAJI ROUSAN | Contact No | 8479932377 |
| Address | 83 MALLICKPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 14 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||