Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05220 | Date 04/01/2022 |
| Token No | SM/21-22/1782 04/01/2022 | Serial | 019 |
| Patient Name | Mr. BIDHAN CHANDRA GORAI | Contact No | 9614231388 |
| Address | 8/D DEY STREET | Age | 44 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||