Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06151 | Date 20/06/2022 |
| Token No | SM/22-23/3490 20/06/2022 | Serial | 007 |
| Patient Name | Mr. KAILASH BARIK | Contact No | NOT GIVEN |
| Address | 44/1 N L BHATTACHARJEE STREET | Age | 81 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||