Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12057 | Date 04/09/2024 |
| Token No | SM/24-25/18576 04/09/2024 | Serial | 012 |
| Patient Name | Mr. ASHOK KUMAR HALDER | Contact No | 9830188005 |
| Address | 61C T B STREET | Age | 74 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||