Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05421 | Date 14/02/2022 |
| Token No | SM/21-22/2145 14/02/2022 | Serial | 003 |
| Patient Name | Mr. RAJDIP DEY | Contact No | 7980265074 |
| Address | 5/D GOPAL GANGULY LANE | Age | 29 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||