Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 03300 | Date 01/12/2022 |
| Token No | SM/22-23/4923 01/12/2022 | Serial | 005 |
| Patient Name | Mr. BIJAY KUMAR SHAW | Contact No | 8100144652 |
| Address | 70/A/2/92/1 KHATIR BAZAR LANE SERAMPORE 712202 | Age | 24 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||