Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10319 | Date 07/09/2023 |
| Token No | SM/22-23/12310 07/09/2023 | Serial | 003 |
| Patient Name | Mr. MONOJ KUMAR SHAW | Contact No | 8583849386 |
| Address | 6 RAM SITA LANE NAYA BAGAN | Age | 40 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||