Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05333 | Date 21/01/2022 |
| Token No | SM/21-22/1966 21/01/2022 | Serial | 001 |
| Patient Name | Mr. ARKA KUNDU | Contact No | 8583965620 |
| Address | 52 N L BHATTACHARJEE STREET | Age | 27 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||