Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07663 | Date 15/11/2022 |
| Token No | SM/22-23/6316 15/11/2022 | Serial | 003 |
| Patient Name | Mr. RABIN DUTTA | Contact No | 6289404483 |
| Address | 34 DEY BAGAN | Age | 39 Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||