Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05929 | Date 24/05/2022 |
| Token No | SM/22-23/3094 24/05/2022 | Serial | 033 |
| Patient Name | Mr. AMAN JANA | Contact No | NOT GIVEN |
| Address | 9 NO. LINE | Age | 42 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||