Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 03599 | Date 10/12/2019 |
| Token No | SM/21-22/460 22/06/2021 | Serial | 001 |
| Patient Name | Mr. ANIL SAHA | Contact No | NOT GIVEN |
| Address | 12/A MIAJAN DARJI LANE, MALLICK PARA | Age | 65 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||