Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06090 | Date 14/06/2022 |
| Token No | SM/22-23/3388 14/06/2022 | Serial | 008 |
| Patient Name | Mr. RODDUR ROY CHOWDHURY | Contact No | NOT GIVEN |
| Address | 10 CHOWDHURY PARA LANE | Age | 42 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||