Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01256 | Date 31/10/2018 |
| Token No | SM/22-23/3359 13/06/2022 | Serial | 010 |
| Patient Name | Mr. BACCHU DAS | Contact No | NOT GIVEN |
| Address | MANIK TALA | Age | 52 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||