Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02782 | Date 24/09/2022 |
| Token No | SM/22-23/3028 24/09/2022 | Serial | 037 |
| Patient Name | Mr. PALY DUTTA | Contact No | 9804641773 |
| Address | 43/46/C/2 PRABASHNAGAR SERAMPORE 712249 | Age | 40 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||