Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02483 | Date 16/07/2019 |
| Token No | SM/22-23/4237 01/08/2022 | Serial | 025 |
| Patient Name | Mr. HEMANTA KARMAKAR | Contact No | 9093909154 |
| Address | 56 THAKUR BATI STREET | Age | 50 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||