Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 04201 | Date 19/05/2023 |
| Token No | SM/25-26/2045 15/05/2025 | Serial | 008 |
| Patient Name | Mr. DIPAK SHAW | Contact No | 9088174618 |
| Address | 97/F/5 PRAVASHNAGAR SERAMPORE 712249 | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||