Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06808 | Date 23/08/2022 |
| Token No | SM/22-23/4670 23/08/2022 | Serial | 023 |
| Patient Name | Mr. SIBU DAS | Contact No | NOT GIVEN |
| Address | DOSTI LANE | Age | 42 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||