Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01287 | Date 16/11/2018 |
| Token No | SM/22-23/15021 04/03/2024 | Serial | 006 |
| Patient Name | Mr. GOUTAM BANERJEE | Contact No | NOT GIVEN |
| Address | THAKURBATI ST | Age | 64 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||