Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02013 | Date 23/06/2022 |
| Token No | SM/22-23/772 23/06/2022 | Serial | 021 |
| Patient Name | Mr. ANEEK GUHA | Contact No | 9062422485 |
| Address | 52 BHATTACHARYA GARDEN LANE NABAGRAM MALLICKPARA SERAMPORE HOOGHLY 712203 | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||