Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05371 | Date 31/01/2022 |
| Token No | SM/21-22/2050 31/01/2022 | Serial | 014 |
| Patient Name | Mr. BABUSONA PAJA | Contact No | 9073731251 |
| Address | 78 DEY STREET | Age | 31 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||