Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06429 | Date 22/07/2022 |
| Token No | SM/22-23/3962 22/07/2022 | Serial | 001 |
| Patient Name | Mr. AMAR DAS | Contact No | 9051916719 |
| Address | 111 G T ROAD | Age | 86 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||