Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07005 | Date 09/09/2022 |
| Token No | SM/22-23/5034 09/09/2022 | Serial | 015 |
| Patient Name | Mr. LALAN ROY | Contact No | 9128151993 |
| Address | 12 NO LINE | Age | 62 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||