Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02698 | Date 14/09/2022 |
| Token No | SM/22-23/2731 14/09/2022 | Serial | 023 |
| Patient Name | Mr. GHANTU DEY | Contact No | 9038904885 |
| Address | PRABASHNAGAR CHAKLAPARA SERAMPORE 712249 | Age | 10 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 30 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||