Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04235 | Date 27/05/2023 |
| Token No | SM/22-23/9125 27/05/2023 | Serial | 012 |
| Patient Name | Mr. SK MEHERAB | Contact No | 9051606468 |
| Address | 9 MALLICKPARA LANE SERAMPORE 712203 | Age | 11 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||