Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05308 | Date 17/01/2022 |
| Token No | SM/21-22/1906 17/01/2022 | Serial | 004 |
| Patient Name | Mr. PRADIP KUMAR BHATTACHARJEE | Contact No | 9123942556 |
| Address | 108C PATUA PARA LANE | Age | 70 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||