Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01856 | Date 09/06/2022 |
| Token No | SM/22-23/8041 08/04/2023 | Serial | 004 |
| Patient Name | Mr. SWAPAN MANNA | Contact No | 9874096524 |
| Address | 206/A RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 57 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||