Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04735 | Date 07/08/2023 |
| Token No | SM/22-23/11577 09/08/2023 | Serial | 035 |
| Patient Name | Mr. AIYUSH SIL | Contact No | 8910610486 |
| Address | 65/7/4/A MAHESH JANNAGAR ROAD SERAMPORE 712249 | Age | 9 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||