Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 07809 | Date 25/11/2022 |
| Token No | SM/22-23/6638 25/11/2022 | Serial | 017 |
| Patient Name | Mr. RAM BALAN CHOWDHURY | Contact No | 6290818038 |
| Address | 15 LBS ROAD | Age | 67 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||