Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05559 | Date 17/03/2022 |
| Token No | SM/22-23/10589 04/07/2023 | Serial | 011 |
| Patient Name | Mr. DEBIPARASAD KHATIK | Contact No | 8585876464 |
| Address | 79 DEY STREET | Age | 48 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||