Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02274 | Date 20/07/2022 |
| Token No | SM/22-23/8804 13/05/2023 | Serial | 011 |
| Patient Name | Mr. SURAJ RAY | Contact No | 7059319118 |
| Address | 10 NO HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 8 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||