Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06759 | Date 17/08/2022 |
| Token No | SM/22-23/4578 17/08/2022 | Serial | 010 |
| Patient Name | Mr. KUNTAL GHORUI | Contact No | NOT GIVEN |
| Address | 310 G T ROAD | Age | 23 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||