Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02693 | Date 13/09/2022 |
| Token No | SM/22-23/2692 13/09/2022 | Serial | 015 |
| Patient Name | Mr. AYUSH ROY | Contact No | 8617270696 |
| Address | 34/B/63 B B GHOSH ROAD SERAMPORE 712203 | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||