Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 03199 | Date 19/11/2022 |
| Token No | SM/22-23/4577 19/11/2022 | Serial | 022 |
| Patient Name | Mr. PREETAM MONDAL | Contact No | 9007194797 |
| Address | 10/M HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 8 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||