Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01126 | Date 04/03/2020 |
| Token No | SM/22-23/7307 06/03/2023 | Serial | 007 |
| Patient Name | Mr. AJOY SHUILI | Contact No | 8981540617 |
| Address | B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712203 | Age | 18 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||