Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01654 | Date 25/05/2022 |
| Token No | SM/22-23/90 25/05/2022 | Serial | 002 |
| Patient Name | Mr. SUBIR DUTTA | Contact No | 9007082827 |
| Address | 29A MALLICKPARA SERAMPORE 712203 | Age | 51 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||