Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07105 | Date 22/09/2022 |
| Token No | SM/22-23/5254 22/09/2022 | Serial | 001 |
| Patient Name | Mr. TARAK DAS | Contact No | 7890293438 |
| Address | TALPUKUR, LOKENATHPOLLY | Age | 43 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||