Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01122 | Date 04/03/2020 |
| Token No | SM/22-23/2128 18/08/2022 | Serial | 019 |
| Patient Name | Mr. SK ASIS | Contact No | 8777416034 |
| Address | 7 NO TARAPUKUR LANE CHAKAPARA SERAMPORE 712203 | Age | 10 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||