Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 07205 | Date 12/10/2022 |
| Token No | SM/22-23/10023 07/06/2023 | Serial | 001 |
| Patient Name | Mr. JIBON CHANDRA GOPE | Contact No | NOT GIVEN |
| Address | 19 L B S ROAD | Age | 78 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||