Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03110 | Date 10/11/2022 |
| Token No | SM/22-23/4268 10/11/2022 | Serial | 041 |
| Patient Name | Mr. CHANDAN GOSWAMI | Contact No | 9088550582 |
| Address | 97/P/5 GURU GARDEN ROAD SERAMPORE 712249 | Age | 37 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||