Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04410 | Date 03/07/2023 |
| Token No | SM/22-23/10066 03/07/2023 | Serial | 009 |
| Patient Name | Mr. PRANABENDU CHTTARAJ | Contact No | 9088657028 |
| Address | 31/A TARAPUKUR LANE MALIIKPARA SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||