Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03169 | Date 17/11/2022 |
| Token No | SM/22-23/4493 17/11/2022 | Serial | 016 |
| Patient Name | Mr. RAUNAK KUMAR RAM | Contact No | 9831114586 |
| Address | 65/A/8 M J ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 13 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||