Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 01317 | Date 31/03/2020 |
| Token No | SM/25-26/12165 20/12/2025 | Serial | 005 |
| Patient Name | Mr. ANISH KUMAR GUPTA | Contact No | 8420288829 |
| Address | 43/46/F/1/A PRAVASHNAGAR SERAMPORE 712249 | Age | 21 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||