Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 02987 | Date 28/10/2022 |
| Token No | SM/22-23/3788 28/10/2022 | Serial | 008 |
| Patient Name | Mr. DIBYAMOY DEY SARKAR | Contact No | 7450057155 |
| Address | 71/G PATUA PARA LANE SERAMPORE 712201 | Age | 17 Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||