Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 03232 | Date 23/11/2022 |
| Token No | SM/22-23/4677 23/11/2022 | Serial | 034 |
| Patient Name | Mr. BISWANATH CHAKRABORTY | Contact No | 9239006653 |
| Address | 21/A/5 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 55 Male |
| Token For | Medicine, | Charge | Free |
| B.P | 130/80 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||