Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07664 | Date 15/11/2022 |
| Token No | SM/22-23/6318 15/11/2022 | Serial | 005 |
| Patient Name | Mr. RABI DAS | Contact No | 7044157665 |
| Address | 47 DHULIPARA LANE | Age | 57 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||