Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03193 | Date 19/11/2022 |
| Token No | SM/22-23/4561 19/11/2022 | Serial | 006 |
| Patient Name | Mr. AMAL KANTA DEB | Contact No | 9007468350 |
| Address | 65/22/9 MAHESH JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 56 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||