Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04380 | Date 13/05/2021 |
| Token No | SM/21-22/255 13/05/2021 | Serial | 001 |
| Patient Name | Mr. RADHA RAMAN KOLAY | Contact No | 9830548529 |
| Address | 23A/1 PANCHANAN TALA LANE | Age | 61 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||