Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06100 | Date 15/06/2022 |
| Token No | SM/22-23/3409 15/06/2022 | Serial | 003 |
| Patient Name | Mr. DILIP PAL | Contact No | 9433448701 |
| Address | DOSTI LANE | Age | 45 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||