Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04415 | Date 31/05/2021 |
| Token No | SM/21-22/308 31/05/2021 | Serial | 001 |
| Patient Name | Mr. ARVIND SHA | Contact No | 9748197677 |
| Address | 18A K C BHATTACHARJEE DEY STREET | Age | 26 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||