Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 06735 | Date 16/08/2022 |
| Token No | SM/22-23/4537 16/08/2022 | Serial | 012 |
| Patient Name | Mr. PRAKASH CHANDRA ROY | Contact No | 8777281106 |
| Address | 20 JAMIDAR BAGAN LANE | Age | 45 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||