Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01616 | Date 23/05/2022 |
| Token No | SM/22-23/36 23/05/2022 | Serial | 005 |
| Patient Name | Mr. KANAILAL DAS | Contact No | 8777690935 |
| Address | 139 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 82 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||