Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09343 | Date 14/06/2023 |
| Token No | SM/22-23/10191 14/06/2023 | Serial | 013 |
| Patient Name | Mr. BISWANATH PARIYALI | Contact No | NOT GIVEN |
| Address | L.M. BHATTACHARYA STREET | Age | 52 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||