Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07171 | Date 10/10/2022 |
| Token No | SM/22-23/5379 10/10/2022 | Serial | 012 |
| Patient Name | Mr. BHOMBOL DAS | Contact No | 9062376072 |
| Address | PANCHANAN TALA LANE | Age | 51 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||