Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04820 | Date 14/08/2023 |
| Token No | SM/22-23/11803 14/08/2023 | Serial | 011 |
| Patient Name | Mr. PANCHU GOPAL SARKAR | Contact No | 6289467707 |
| Address | 147 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 71 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||