Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06340 | Date 13/07/2022 |
| Token No | SM/22-23/3840 13/07/2022 | Serial | 010 |
| Patient Name | Mr. PALLAB SHA | Contact No | NOT GIVEN |
| Address | RAM SITA LANE | Age | 41 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||