Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 04353 | Date 04/05/2021 |
| Token No | SM/22-23/13254 09/11/2023 | Serial | 003 |
| Patient Name | Mr. SHIBU CHARAN BOLEL | Contact No | 9830734476 |
| Address | 4 DR. T P BHATTACHARJEE STREET | Age | 71 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||