Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 00633 | Date 31/12/2019 |
| Token No | SM/22-23/6948 20/02/2023 | Serial | 025 |
| Patient Name | Mr. SAMIR KUMAR CHAKRABORTY | Contact No | 9433151565 |
| Address | 25A/3/1 KUMIRJALA ROAD SERAMPORE 712203 | Age | 74 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||