Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05493 | Date 07/03/2022 |
| Token No | SM/21-22/2322 07/03/2022 | Serial | 003 |
| Patient Name | Mr. NARAYAN CHANDRA KARMAKAR | Contact No | NOT GIVEN |
| Address | 56 AKHRA BATI LANE | Age | 65 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||