Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05873 | Date 18/05/2022 |
| Token No | SM/22-23/3011 18/05/2022 | Serial | 010 |
| Patient Name | Mr. DIBYAJYOTI LAHIRI | Contact No | 9038918201 |
| Address | 123/A THAKUR BATI STREET | Age | 28 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||