Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01809 | Date 01/06/2022 |
| Token No | SM/22-23/326 01/06/2022 | Serial | 054 |
| Patient Name | Mr. SURAJIT DEY | Contact No | 9331097943 |
| Address | PURBAPARA GHORAMARA SERAMPORE 712203 | Age | 16 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||