Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06176 | Date 21/06/2022 |
| Token No | SM/22-23/3523 21/06/2022 | Serial | 016 |
| Patient Name | Mr. MONTU DAS | Contact No | NOT GIVEN |
| Address | 1/1 M.P.LANE | Age | 42 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||