Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03052 | Date 04/11/2022 |
| Token No | SM/22-23/4090 05/11/2022 | Serial | 012 |
| Patient Name | Mr. SURENDRA RABIDAS | Contact No | 7449774193 |
| Address | 66/B/1/A GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 41 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||