Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 06078 | Date 13/06/2022 |
| Token No | SM/22-23/3370 13/06/2022 | Serial | 021 |
| Patient Name | Mr. SURAJIT PALCHOWDHURY | Contact No | NOT GIVEN |
| Address | J N LAHIRI ROAD | Age | 39 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||