Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05526 | Date 11/03/2022 |
| Token No | SM/21-22/2396 11/03/2022 | Serial | 011 |
| Patient Name | Mr. BHRIGU NATH DAS | Contact No | NOT GIVEN |
| Address | 7 DEY GHAT LANE | Age | 71 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||