Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 06719 | Date 13/08/2022 |
| Token No | SM/22-23/4513 13/08/2022 | Serial | 002 |
| Patient Name | Mr. SAILEN DAS | Contact No | 9883524541 |
| Address | 5/16 BAISHNAB PARA 1ST LANE | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||