Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03058 | Date 05/11/2022 |
| Token No | SM/22-23/4128 07/11/2022 | Serial | 027 |
| Patient Name | Mr. SAJAL KUMAR DEY | Contact No | 6290041624 |
| Address | 43/12/A/2 PRABASHNAGAR SERAMPORE 712249 | Age | 53 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 66 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||