Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01074 | Date 25/02/2020 |
| Token No | SM/22-23/2886 21/09/2022 | Serial | 006 |
| Patient Name | Mr. KHUSI GOPAL DEY | Contact No | 8926777886 |
| Address | 30/13 TARAPUKUR LANE SERAMPORE 712203 | Age | 67 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||