Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04383 | Date 13/05/2021 |
| Token No | SM/21-22/260 13/05/2021 | Serial | 006 |
| Patient Name | Mr. SWAPAN CHATTERJEE | Contact No | NOT GIVEN |
| Address | 167C THAKUR BATI STREET | Age | 68 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||