Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00069 | Date 04/08/2018 |
| Token No | SM/22-23/2583 01/04/2022 | Serial | 004 |
| Patient Name | Mr. DEBIPRASAD CHATTERJEE | Contact No | 8777786001 |
| Address | 17 L. M BHATTACHARYA STREET | Age | 63 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||