Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10140 | Date 25/08/2023 |
| Token No | SM/22-23/11977 25/08/2023 | Serial | 019 |
| Patient Name | Mr. BIBHASH DAS | Contact No | 9830301097 |
| Address | 21A DOSTI LANE | Age | 28 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||