Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05307 | Date 17/01/2022 |
| Token No | SM/24-25/20273 18/12/2024 | Serial | 025 |
| Patient Name | Mr. BINOD BARIK | Contact No | NOT GIVEN |
| Address | 52 NANILAL BHATTACHARJEE STREET | Age | 48 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||