Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10102 | Date 23/08/2023 |
| Token No | SM/22-23/11888 23/08/2023 | Serial | 010 |
| Patient Name | Mr. SAMIRENDRANATH LAHIRI | Contact No | 9432228560 |
| Address | 48/33 BHAGIRTAHI LANE | Age | 77 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||