Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04516 | Date 22/06/2021 |
| Token No | SM/21-22/2079 02/02/2022 | Serial | 005 |
| Patient Name | Mr. SWAPAN SRIMANI | Contact No | 9231619714 |
| Address | BHATTACHARYA STREET | Age | 73 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||