Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05764 | Date 26/04/2022 |
| Token No | SM/22-23/2826 26/04/2022 | Serial | 005 |
| Patient Name | Mr. SWARUP KUMAR DEY | Contact No | 8902559766 |
| Address | 5B/2 GOPAL GANGULY LANE | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||