Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04515 | Date 22/06/2021 |
| Token No | SM/21-22/464 22/06/2021 | Serial | 005 |
| Patient Name | Mr. RIPAN DAS | Contact No | 8017481988 |
| Address | TALPUKUR | Age | 46 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||