Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02061 | Date 27/06/2022 |
| Token No | SM/22-23/2473 05/09/2022 | Serial | 022 |
| Patient Name | Mr. SAMBHU NATH GHATAK | Contact No | 9681537932 |
| Address | 65/16 WEST JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 80 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||