Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07961 | Date 16/12/2022 |
| Token No | SM/22-23/7025 16/12/2022 | Serial | 005 |
| Patient Name | Mr. SUSANTA BISWAL | Contact No | 6289525210 |
| Address | 45 DR. N L BHATTACHARJEE STREET | Age | 49 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||