Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07016 | Date 12/09/2022 |
| Token No | SM/22-23/5057 12/09/2022 | Serial | 004 |
| Patient Name | Mr. SAYAK DAS | Contact No | 9830986589 |
| Address | 40 DOSTI LANE | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||