Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05739 | Date 21/04/2022 |
| Token No | SM/22-23/2785 21/04/2022 | Serial | 009 |
| Patient Name | Mr. MODON MOHAN KOLEY | Contact No | 9903862723 |
| Address | CHOWDHURY PARA | Age | 66 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||