Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 07362 | Date 04/07/2024 |
| Token No | SM/24-25/27325 29/08/2024 | Serial | 017 |
| Patient Name | Mr. PANCHU GOPAL GOPE | Contact No | 6289056694 |
| Address | 168 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 60 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||