Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 03704 | Date 07/01/2020 |
| Token No | SM/22-23/4445 10/08/2022 | Serial | 030 |
| Patient Name | Mr. KAUSTAV DOLUI | Contact No | 9838582009 |
| Address | MAHESH BOSE PARA | Age | 30 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||