Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06781 | Date 22/08/2022 |
| Token No | SM/22-23/4616 22/08/2022 | Serial | 004 |
| Patient Name | Mr. PAWAN ROY | Contact No | NOT GIVEN |
| Address | KUNDU BARI, SERAMPORE COLLEGE | Age | 16 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||