Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06567 | Date 30/07/2022 |
| Token No | SM/22-23/4208 30/07/2022 | Serial | 005 |
| Patient Name | Mr. BIBHUPADA SARKAR | Contact No | 9874863723 |
| Address | 2 DOCTOR BAGAN LANE | Age | 54 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||