Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 10763 | Date 09/11/2023 |
| Token No | SM/22-23/13253 09/11/2023 | Serial | 002 |
| Patient Name | Mr. MOHON CHANDRA DAS | Contact No | 6783915174 |
| Address | MANIKTALA, 9 POTUA PARA | Age | 62 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||