Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08784 | Date 18/04/2023 |
| Token No | SM/22-23/8971 18/04/2023 | Serial | 032 |
| Patient Name | Mr. GOUTAM PRASAD BANERJEE | Contact No | 9836545181 |
| Address | 14 DEY STREET | Age | 67 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||