Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04039 | Date 22/09/2020 |
| Token No | SM/21-22/482 23/06/2021 | Serial | 012 |
| Patient Name | Mr. LOKENATH SAHA | Contact No | 8697627846 |
| Address | 61 B MALLICK PARA | Age | 41 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||