Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06541 | Date 28/07/2022 |
| Token No | SM/22-23/4163 28/07/2022 | Serial | 025 |
| Patient Name | Mr. PRADIP SAMANTA | Contact No | NOT GIVEN |
| Address | 120 PANDIT KALINATH BHATTACHARYA ST | Age | 45 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||