Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05186 | Date 22/12/2021 |
| Token No | SM/22-23/6470 21/11/2022 | Serial | 010 |
| Patient Name | Mr. SUMAN BANERJEE | Contact No | 9330951199 |
| Address | JOLKOL OFFICE STAFF | Age | 37 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||