Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06430 | Date 22/07/2022 |
| Token No | SM/22-23/3963 22/07/2022 | Serial | 002 |
| Patient Name | Mr. TAPAS DAS | Contact No | 9436780050 |
| Address | 44 DEY STREET | Age | 50 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||