Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05879 | Date 19/05/2022 |
| Token No | SM/22-23/3027 19/05/2022 | Serial | 010 |
| Patient Name | Mr. ASHOK DAS.. | Contact No | NOT GIVEN |
| Address | 15A PATUA PARA LANE | Age | 47 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||