Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01141 | Date 07/03/2020 |
| Token No | SM/25-26/20652 27/08/2026 | Serial | 017 |
| Patient Name | Mr. SHIBAM GUPTA | Contact No | 7890085109 |
| Address | 13/52 B B GHOSH ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 10 Years,7 Months,25 Days Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||