Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01608 | Date 20/05/2022 |
| Token No | SM/22-23/8878 16/05/2023 | Serial | 018 |
| Patient Name | Mr. SHAMBHU ADHIKARI | Contact No | 9903415793 |
| Address | 65/25 PRABASHNAGAR CHAKLAPARA SERAMPORE 712249 | Age | 63 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||