Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 04310 | Date 12/06/2023 |
| Token No | SM/22-23/9497 12/06/2023 | Serial | 016 |
| Patient Name | Mr. NIRDHAN DAS | Contact No | 9883503772 |
| Address | 5/33 BAISHNAB PARA 1ST LANE MAHESH 1 SERAMPORE 712202 | Age | 66 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||