Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 03510 | Date 28/12/2022 |
| Token No | SM/22-23/5697 28/12/2022 | Serial | 015 |
| Patient Name | Mr. KISTO CHANDRA DAS | Contact No | 9123939766 |
| Address | 65/A WEST JANNAGAR ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 76 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||