Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05204 | Date 03/01/2022 |
| Token No | SM/21-22/1760 03/01/2022 | Serial | 016 |
| Patient Name | Mr. CHANDAN SAHA | Contact No | 6290599628 |
| Address | 25 BAZAR BYE LANE | Age | 56 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||