Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 05234 | Date 05/01/2022 |
| Token No | SM/21-22/1802 05/01/2022 | Serial | 017 |
| Patient Name | Mr. MOLOY KUMAR BHADRA | Contact No | 8902800438 |
| Address | 71A GANGULY BAGAN | Age | 64 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||