Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02592 | Date 31/08/2022 |
| Token No | SM/22-23/2386 31/08/2022 | Serial | 021 |
| Patient Name | Mr. UDAY SHAW | Contact No | 9674513019 |
| Address | 97/F/4/1 DHOBIYA PARA PRABASHNAGAR SERAMPORE 712249 | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 21 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||