Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 08336 | Date 13/02/2023 |
| Token No | SM/22-23/14567 01/02/2024 | Serial | 039 |
| Patient Name | Mr. MANIK ORANG | Contact No | 0326526171 |
| Address | 96 DEY STREET | Age | 51 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||