Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10358 | Date 12/09/2023 |
| Token No | SM/22-23/12400 12/09/2023 | Serial | 005 |
| Patient Name | Mr. PALASH DOLUI | Contact No | 7439340520 |
| Address | 4/A S B GHOSH LANE, 3RD BYE LANE | Age | 34 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||