Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 06323 | Date 11/07/2022 |
| Token No | SM/22-23/3814 11/07/2022 | Serial | 002 |
| Patient Name | Mr. DASHARATH DAS | Contact No | NOT GIVEN |
| Address | J N LAHIRI ROAD | Age | 49 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||