Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09813 | Date 31/07/2023 |
| Token No | SM/22-23/11268 31/07/2023 | Serial | 014 |
| Patient Name | Mr. KAMLESH ROY | Contact No | NOT GIVEN |
| Address | 8 RAM SITA LANE | Age | 25 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||