Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06086 | Date 14/06/2022 |
| Token No | SM/22-23/3383 14/06/2022 | Serial | 003 |
| Patient Name | Mr. RIPON SHIL | Contact No | 9883993126 |
| Address | TALPUKUR LOKENATH PALLY | Age | 40 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||