Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02349 | Date 29/07/2022 |
| Token No | SM/22-23/1708 29/07/2022 | Serial | 034 |
| Patient Name | Mr. PROSIK PARASRAMPURIA | Contact No | |
| Address | HARIPARA LANE STANDARD FARMACY SERAMPORE 712203 | Age | 30 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||