Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10136 | Date 25/08/2023 |
| Token No | SM/22-23/11972 25/08/2023 | Serial | 014 |
| Patient Name | Mr. SAMBHU ROY | Contact No | 8622067020 |
| Address | 12/558 INDIA JUTE MILL | Age | 35 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||