Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06418 | Date 20/07/2022 |
| Token No | SM/22-23/3944 20/07/2022 | Serial | 028 |
| Patient Name | Mr. DHIREN PRAMANIK | Contact No | NOT GIVEN |
| Address | POTUA PARA | Age | 43 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||