Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07813 | Date 25/11/2022 |
| Token No | SM/22-23/6649 25/11/2022 | Serial | 028 |
| Patient Name | Mr. JAYDIP DAS | Contact No | 9051071031 |
| Address | 16/A DUTTA BAGAN LANE | Age | 50 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||