Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07667 | Date 15/11/2022 |
| Token No | SM/22-23/6321 15/11/2022 | Serial | 008 |
| Patient Name | Mr. PRATAP DAS | Contact No | 8961582297 |
| Address | 12 NO LINE, RAM SITA LANE | Age | 45 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||