Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 10587 | Date 29/09/2023 |
| Token No | SM/22-23/12820 29/09/2023 | Serial | 020 |
| Patient Name | Mr. MADAN DAS | Contact No | 9905696264 |
| Address | 26 T.C. GOSWAMI STREET | Age | 40 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||