Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03228 | Date 23/11/2022 |
| Token No | SM/22-23/4666 23/11/2022 | Serial | 023 |
| Patient Name | Mr. AAYAN MALLICK | Contact No | 8697916625 |
| Address | 28 MIYAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 9 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||