Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05312 | Date 17/01/2022 |
| Token No | SM/21-22/1913 17/01/2022 | Serial | 011 |
| Patient Name | Mr. BASUDEB PAL | Contact No | NOT GIVEN |
| Address | SHIBTALA LANE | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||