Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04533 | Date 25/06/2021 |
| Token No | SM/21-22/496 25/06/2021 | Serial | 005 |
| Patient Name | Mr. SRESTHANGSU SARKAR | Contact No | 9903734374 |
| Address | BAT TALA | Age | 12 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||