Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10131 | Date 25/08/2023 |
| Token No | SM/22-23/11964 25/08/2023 | Serial | 006 |
| Patient Name | Mr. JHULAN ROY | Contact No | 8303356964 |
| Address | 11 NO RAM SITA LANE | Age | 49 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||