Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 00178 | Date 18/08/2018 |
| Token No | SM/22-23/9667 18/05/2023 | Serial | 027 |
| Patient Name | Mr. PRABHAT SAMANTA | Contact No | 7008574890 |
| Address | J N LAHIRI ROAD | Age | 45 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||