Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 05439 | Date 17/02/2022 |
| Token No | SM/21-22/2176 17/02/2022 | Serial | 001 |
| Patient Name | Mr. GOPIKANTA DUTTA | Contact No | 9732534709 |
| Address | NABAGRAM, GHOSHAL PARA | Age | 58 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||