Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10075 | Date 22/08/2023 |
| Token No | SM/22-23/11822 22/08/2023 | Serial | 001 |
| Patient Name | Mr. JAY KUMAR ROY | Contact No | 9088693631 |
| Address | 8 NO LINE, INDIA JUTE MILL | Age | 38 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||