Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06334 | Date 13/07/2022 |
| Token No | SM/22-23/3833 13/07/2022 | Serial | 003 |
| Patient Name | Mr. KALIPADA DAS.. | Contact No | 9748416762 |
| Address | 40 AKHRA BATI LANE | Age | 65 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||