Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07241 | Date 14/10/2022 |
| Token No | SM/22-23/5505 14/10/2022 | Serial | 015 |
| Patient Name | Mr. NAKAI DAS | Contact No | 8697351490 |
| Address | 112A POTUA PARA LANE | Age | 46 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||