Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07172 | Date 10/10/2022 |
| Token No | SM/22-23/11105 21/07/2023 | Serial | 008 |
| Patient Name | Mr. LALAN SHA | Contact No | 7596925015 |
| Address | DEY STREET | Age | 60 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||