Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02641 | Date 06/09/2022 |
| Token No | SM/22-23/10021 30/06/2023 | Serial | 061 |
| Patient Name | Mr. GOURAB DAS | Contact No | 9836381799 |
| Address | 34/B/47 B B GHOSH ROAD SERAMPORE 712203 | Age | 14 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||