Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01963 | Date 21/06/2022 |
| Token No | SM/22-23/655 21/06/2022 | Serial | 003 |
| Patient Name | Mr. SAYAN DAS | Contact No | 9073718332 |
| Address | 65/25/7 JAN NAGAR ROAD SERAMPORE 712249 | Age | 7 YRS Male |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||