Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05359 | Date 28/01/2022 |
| Token No | SM/21-22/2028 28/01/2022 | Serial | 012 |
| Patient Name | Mr. BHOLA MAJHI | Contact No | 8017365345 |
| Address | 136 MANIKTALA DEY BAGAN | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||