Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 03155 | Date 16/11/2022 |
| Token No | SM/22-23/4512 18/11/2022 | Serial | 005 |
| Patient Name | Mr. AYUSH GUPTA | Contact No | 8515010024 |
| Address | 73 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 19 Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||