Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 07078 | Date 19/09/2022 |
| Token No | SM/22-23/5185 19/09/2022 | Serial | 004 |
| Patient Name | Mr. TAPAN DAS | Contact No | 9163674195 |
| Address | N N COLONY | Age | 56 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||