Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00580 | Date 19/12/2019 |
| Token No | SM/22-23/11235 02/08/2023 | Serial | 018 |
| Patient Name | Mr. SHUBHAM KARMAKAR | Contact No | 9051848537 |
| Address | 65/24/4 GURU GARDEN ROAD PRAVASHNAGAR SERAMPORE 712249 | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||