Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06725 | Date 13/08/2022 |
| Token No | SM/22-23/4519 13/08/2022 | Serial | 008 |
| Patient Name | Mr. ASHIM NATH | Contact No | 7003605820 |
| Address | 132/D POTUA PARA | Age | 56 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||