Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06173 | Date 21/06/2022 |
| Token No | SM/22-23/3518 21/06/2022 | Serial | 011 |
| Patient Name | Mr. DILIP RAM | Contact No | 9875328341 |
| Address | 2 GOPAL GANGULY LANE | Age | 28 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||