Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05784 | Date 05/05/2022 |
| Token No | SM/22-23/2870 05/05/2022 | Serial | 009 |
| Patient Name | Mr. BISWANATH DEY | Contact No | 7685886431 |
| Address | 42/A KHASBAGAN LANE | Age | 34 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||