Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03028 | Date 02/11/2022 |
| Token No | SM/22-23/3967 02/11/2022 | Serial | 018 |
| Patient Name | Mr. SAMIR KUMAR CHAKRABORTY | Contact No | 9830590177 |
| Address | 25A/3/1 KUMIRJALA ROAD MALLICKPARA SERAMPORE 712203 | Age | 76 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||