Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05300 | Date 13/01/2022 |
| Token No | SM/21-22/1894 13/01/2022 | Serial | 011 |
| Patient Name | Mr. SUBHAJIT KOLEY | Contact No | 9830548529 |
| Address | 23A/1 PANCHANAN TALA | Age | 24 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||