Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04002 | Date 14/08/2020 |
| Token No | SM/21-22/2257 24/02/2022 | Serial | 005 |
| Patient Name | Mr. SOUMENDRA NATH RAKSHIT | Contact No | 8697607589 |
| Address | 153 THAKUR BATI STREET | Age | 82 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||