Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05022 | Date 01/09/2023 |
| Token No | SM/22-23/12560 01/09/2023 | Serial | 003 |
| Patient Name | Mr. SOUMYAJIT DHAR | Contact No | 9231552763 |
| Address | 5/A TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 17 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||