Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06776 | Date 18/08/2022 |
| Token No | SM/22-23/4600 18/08/2022 | Serial | 010 |
| Patient Name | Mr. RINKU HELA | Contact No | 9681556215 |
| Address | 80/A J.N. LAHIRI ROAD | Age | 40 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||