Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05155 | Date 16/09/2023 |
| Token No | SM/22-23/13162 16/09/2023 | Serial | 012 |
| Patient Name | Mr. SANJAY DAS | Contact No | 9748685695 |
| Address | 55 RAILAND ROAD SERAMPORE 712201 | Age | 10 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 20 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||