Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04103 | Date 27/04/2023 |
| Token No | SM/22-23/10398 11/07/2023 | Serial | 011 |
| Patient Name | Mr. RANAK DEY KARMAKAR | Contact No | 6290182150 |
| Address | 65/A KUMIRJALA ROAD 2ND BYE LANE SERAMPORE 712203 | Age | 15 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||