Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04147 | Date 04/05/2023 |
| Token No | SM/24-25/37250 21/03/2025 | Serial | 041 |
| Patient Name | Mr. SUMIT SHAW | Contact No | 9831345622 |
| Address | 97/F/5 PRAVASHNAGAR SERAMPORE 712249 | Age | 23 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||