Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03075 | Date 19/09/2019 |
| Token No | SM/22-23/6429 17/11/2022 | Serial | 007 |
| Patient Name | Mr. SHIBU DAS | Contact No | 9477603051 |
| Address | 34 DOSTI LANE | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||