Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03900 | Date 11/03/2020 |
| Token No | SM/22-23/6461 21/11/2022 | Serial | 001 |
| Patient Name | Mr. KABUL DAS | Contact No | 9830641606 |
| Address | POTUA PARA LANE | Age | 64 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||