Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06696 | Date 10/08/2022 |
| Token No | SM/22-23/4438 10/08/2022 | Serial | 023 |
| Patient Name | Mr. MONOJ BASAK | Contact No | 9903173227 |
| Address | SASHIBHUSAN GHOSH LANE | Age | 48 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||