Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 08020 | Date 27/12/2022 |
| Token No | SM/22-23/7169 27/12/2022 | Serial | 013 |
| Patient Name | Mr. SUJATO GOSWAMI | Contact No | 8420503802 |
| Address | 9/B RAJNOHAN GOSWAMI LANE | Age | 40 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||