Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02791 | Date 13/08/2019 |
| Token No | SM/22-23/4214 01/08/2022 | Serial | 002 |
| Patient Name | Mr. PARTHA PRATIM PAL | Contact No | 9885252262 |
| Address | PANCHANAN TALA LANE | Age | 39 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||