Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00926 | Date 12/02/2020 |
| Token No | SM/22-23/3559 17/10/2022 | Serial | 061 |
| Patient Name | Mr. AYUSHMAN DOLUI | Contact No | 8420337703 |
| Address | 34/B/19 B B GHOSH ROAD SERAMPORE 712203 | Age | 11 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||