Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07428 | Date 28/10/2022 |
| Token No | SM/22-23/5857 28/10/2022 | Serial | 008 |
| Patient Name | Mr. DEBU DAS | Contact No | 7439464021 |
| Address | 36 DOSTI LANE | Age | 53 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||