Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01694 | Date 27/05/2022 |
| Token No | SM/22-23/142 27/05/2022 | Serial | 003 |
| Patient Name | Mr. SURAJIT CHAKRABORTY | Contact No | 8603591524 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 34 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||