Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 09380 | Date 16/06/2023 |
| Token No | SM/22-23/10278 16/06/2023 | Serial | 014 |
| Patient Name | Mr. INDUBALA DAS | Contact No | NOT GIVEN |
| Address | CHATRA BARUIPARA | Age | 64 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||