Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05905 | Date 24/05/2022 |
| Token No | SM/22-23/3065 24/05/2022 | Serial | 004 |
| Patient Name | Mr. RANJIT BASAK | Contact No | 6289047124 |
| Address | 28/35 SHASHIBHUSAN GHOSH LANE | Age | 70 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||