Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06214 | Date 27/06/2022 |
| Token No | SM/22-23/3607 27/06/2022 | Serial | 003 |
| Patient Name | Mr. DILIP MONDAL | Contact No | NOT GIVEN |
| Address | 5 AKHRA BATI LANE | Age | 52 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||