Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 02150 | Date 06/07/2022 |
| Token No | SM/22-23/9505 12/06/2023 | Serial | 024 |
| Patient Name | Mr. SURYA SEN | Contact No | 9830818973 |
| Address | 53/J J N LAHIRI ROAD SERAMPORE 712201 | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||