Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04076 | Date 24/04/2023 |
| Token No | SM/22-23/8912 17/05/2023 | Serial | 019 |
| Patient Name | Mr. DILIP MONDAL | Contact No | 8100830305 |
| Address | 704 SRIKRISHNANAGAR RISHRA M 712249 | Age | 43 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||