Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03500 | Date 27/12/2022 |
| Token No | SM/22-23/5645 27/12/2022 | Serial | 003 |
| Patient Name | Mr. SANTANU CHAKRABORTY | Contact No | 9674249102 |
| Address | 73A MALLICKPARA LANE SERAMPORE 712203 | Age | 58 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||