Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 01947 | Date 22/04/2019 |
| Token No | SM/22-23/14579 05/02/2024 | Serial | 008 |
| Patient Name | Mr. AJIT KUMAR GHOSH | Contact No | 9836049025 |
| Address | 34/B BAISHNAB PARA 2ND LANE | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||