Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04983 | Date 25/10/2021 |
| Token No | SM/21-22/1268 25/10/2021 | Serial | 006 |
| Patient Name | Mr. GOPESH MUKHERJEE | Contact No | 8017044075 |
| Address | 5 CHATTERJEE LANE | Age | 49 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||