Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 07843 | Date 29/11/2022 |
| Token No | SM/22-23/7691 06/02/2023 | Serial | 006 |
| Patient Name | Mr. AJIT KUMAR GHOSH | Contact No | 8582910752 |
| Address | 34/B BAISHNAB PARA 2ND LANE | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||