Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04674 | Date 03/08/2021 |
| Token No | SM/22-23/13601 07/12/2023 | Serial | 004 |
| Patient Name | Mr. DULAL KUNDU | Contact No | NOT GIVEN |
| Address | KC BHATTACHARJEE STREET | Age | 84 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||