Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01384 | Date 09/04/2020 |
| Token No | SM/22-23/515 13/06/2022 | Serial | 015 |
| Patient Name | Mr. SHUBHOJIT PAKIRA | Contact No | 7595918469 |
| Address | 34/B/36 B B GHOSH ROAD SUKANTA PALLY PRABASHNAGAR 712203 | Age | 10 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||