Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02174 | Date 07/07/2022 |
| Token No | SM/22-23/1181 07/07/2022 | Serial | 003 |
| Patient Name | Mr. SAGAR DUTTA BANIK | Contact No | 6291583047 |
| Address | 1 NO COLONY DAKSHIN RAJYADHARPUR SERAMPORE 712203 | Age | 6 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||