Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07322 | Date 18/10/2022 |
| Token No | SM/22-23/5650 18/10/2022 | Serial | 035 |
| Patient Name | Mr. HARU DAS | Contact No | NOT GIVEN |
| Address | 552A G.T.ROAD | Age | 75 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||