Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02471 | Date 15/07/2019 |
| Token No | SM/22-23/6705 29/11/2022 | Serial | 020 |
| Patient Name | Mr. SK IZAZ | Contact No | 9088025000 |
| Address | 15 ACHARYA K C BHATTACHARJEE STREET | Age | 22 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||