Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06040 | Date 09/06/2022 |
| Token No | SM/22-23/3290 09/06/2022 | Serial | 004 |
| Patient Name | Mr. SAMBHUNATH DAS | Contact No | 9874146629 |
| Address | 32 DOSTI LANE | Age | 52 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||