Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05152 | Date 14/12/2021 |
| Token No | SM/21-22/1618 14/12/2021 | Serial | 009 |
| Patient Name | Mr. SAPTARSHI BANERJEE | Contact No | 9875416867 |
| Address | 46/A THAKUR BATI STREET | Age | 23 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||