Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 07072 | Date 17/09/2022 |
| Token No | SM/22-23/5177 17/09/2022 | Serial | 002 |
| Patient Name | Mr. TARAK KOSTA | Contact No | 8961852478 |
| Address | 1 B L C MILLS ROAD | Age | 39 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||