Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06041 | Date 09/06/2022 |
| Token No | SM/22-23/12015 28/08/2023 | Serial | 017 |
| Patient Name | Mr. GOBINDA DHARA | Contact No | 9002757348 |
| Address | 14 DEY GHAT LANE | Age | 61 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||