Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06931 | Date 06/09/2022 |
| Token No | SM/22-23/4902 06/09/2022 | Serial | 017 |
| Patient Name | Mr. RAJ RAJESWAR CHAKRABORTY | Contact No | 9433508550 |
| Address | 33/1 PATUA PARA LANE | Age | 14 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||