Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04992 | Date 29/08/2023 |
| Token No | SM/22-23/12470 29/08/2023 | Serial | 005 |
| Patient Name | Mr. SHIRSENDU CHATTARAJ | Contact No | 9088657028 |
| Address | 31/A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 13 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||