Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05041 | Date 12/11/2021 |
| Token No | SM/21-22/1378 12/11/2021 | Serial | 003 |
| Patient Name | Mr. SANJIB BAG | Contact No | 9073333859 |
| Address | 3 A B GARDEN LANE | Age | 33 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||