Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05208 | Date 04/01/2022 |
| Token No | SM/21-22/1767 04/01/2022 | Serial | 004 |
| Patient Name | Mr. SWAPANJOY DAS | Contact No | 9883261577 |
| Address | 5/C NANDALAL ADHIKARI LANE | Age | 8 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||