Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06623 | Date 04/08/2022 |
| Token No | SM/22-23/4309 04/08/2022 | Serial | 023 |
| Patient Name | Mr. SAMIR DEY | Contact No | |
| Address | 5/5 BAISNAB PARA 1ST LANE | Age | 40 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||