Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00392 | Date 16/11/2019 |
| Token No | SM/22-23/12415 28/08/2023 | Serial | 017 |
| Patient Name | Mr. SHUBANKAR KANTI | Contact No | 9088993392 |
| Address | 9/A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 6 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 14 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||