Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 07490 | Date 03/11/2022 |
| Token No | SM/22-23/5977 03/11/2022 | Serial | 005 |
| Patient Name | Mr. BISHAL KUMAR ROY | Contact No | 8777728581 |
| Address | 22 BOSEPARA LANE | Age | 24 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||