Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03474 | Date 22/11/2019 |
| Token No | SM/21-22/2099 07/02/2022 | Serial | 005 |
| Patient Name | Mr. BIRJENDU RAKSHIT | Contact No | 9674510989 |
| Address | 49 PATUA PARA LANE | Age | 72 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||