Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05346 | Date 27/01/2022 |
| Token No | SM/21-22/2003 27/01/2022 | Serial | 001 |
| Patient Name | Mr. MOHAMMAD SAFIK | Contact No | NOT GIVEN |
| Address | JHAUTALA, SERAMPORE | Age | 50 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||