Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 04235 | Date 05/04/2021 |
| Token No | SM/21-22/12 05/04/2021 | Serial | 001 |
| Patient Name | Mr. NANDALAL CHOWDHURY | Contact No | NOT GIVEN |
| Address | 34 K M BHATTACHARYA STREET | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||