Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04525 | Date 23/06/2021 |
| Token No | SM/22-23/3871 18/07/2022 | Serial | 006 |
| Patient Name | Mr. ALAMGIR MONDAL | Contact No | NOT GIVEN |
| Address | DEYST, SERAMPORE | Age | 13 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||