Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00133 | Date 08/08/2018 |
| Token No | SM/22-23/5864 28/10/2022 | Serial | 015 |
| Patient Name | Mr. SUBHASISH CHAKRABORTY | Contact No | |
| Address | Age | 46 Male | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||