Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06372 | Date 19/07/2022 |
| Token No | SM/22-23/3889 19/07/2022 | Serial | 012 |
| Patient Name | Mr. MALAY BANERJEE | Contact No | 9836847156 |
| Address | 53 DHULIPARA LANE | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||