Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05303 | Date 14/01/2022 |
| Token No | SM/21-22/1899 14/01/2022 | Serial | 002 |
| Patient Name | Mr. SOMNATH CHATTERJEE | Contact No | NOT GIVEN |
| Address | THAKURBATI STREET | Age | 70 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||