Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03540 | Date 30/12/2022 |
| Token No | SM/22-23/15002 02/11/2023 | Serial | 024 |
| Patient Name | Mr. SHIVAM KUMAR SHAW | Contact No | 9831495920 |
| Address | 65/19/6 WEST JANNAGAR ROAD SERAMPORE 712201 | Age | 14 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||