Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 03405 | Date 15/12/2022 |
| Token No | SM/22-23/5316 15/12/2022 | Serial | 006 |
| Patient Name | Mr. ARIJIT GHOSH | Contact No | 9874575461 |
| Address | 39/A/1 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 14 Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||