Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07071 | Date 17/09/2022 |
| Token No | SM/22-23/5176 17/09/2022 | Serial | 001 |
| Patient Name | Mr. SHIBNATH PAL | Contact No | 9674858788 |
| Address | POTUA PARA LANE | Age | 56 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||