Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07998 | Date 21/12/2022 |
| Token No | SM/22-23/7093 21/12/2022 | Serial | 014 |
| Patient Name | Mr. BARHAM DEV ROY | Contact No | 8084599625 |
| Address | DEY STREET | Age | 50 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||