Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04215 | Date 31/03/2021 |
| Token No | SM/24-25/15723 15/04/2024 | Serial | 004 |
| Patient Name | Mr. ANNADA MOHAN BISWAS | Contact No | NOT GIVEN |
| Address | 90/A THAKUR BATI STERET | Age | 56 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||