Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06847 | Date 30/08/2022 |
| Token No | SM/22-23/4770 30/08/2022 | Serial | 015 |
| Patient Name | Mr. KOUSTABH BANERJEE | Contact No | NOT GIVEN |
| Address | HARIPAL | Age | 35 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||