Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05051 | Date 16/11/2021 |
| Token No | SM/21-22/1397 16/11/2021 | Serial | 002 |
| Patient Name | Mr. POJA DAS | Contact No | 8420308867 |
| Address | MANIKTALA | Age | 40 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||