Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07193 | Date 11/10/2022 |
| Token No | SM/22-23/5409 11/10/2022 | Serial | 009 |
| Patient Name | Mr. SANTOSH DAS | Contact No | 7890573951 |
| Address | 25B PATUA PARA LANE | Age | 39 Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||