Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03289 | Date 24/10/2019 |
| Token No | SM/22-23/5785 25/10/2022 | Serial | 013 |
| Patient Name | Mr. PACHU GOPAL DAS | Contact No | 9062384211 |
| Address | 9 PATUA PARA LANE | Age | 76 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||