Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04396 | Date 18/05/2021 |
| Token No | SM/21-22/278 18/05/2021 | Serial | 009 |
| Patient Name | Mr. TARUN BANERJEE | Contact No | 9748827307 |
| Address | 93 DEY STREET | Age | 64 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||