Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07188 | Date 11/10/2022 |
| Token No | SM/22-23/7224 28/12/2022 | Serial | 021 |
| Patient Name | Mr. MONORANJAN MALLICK | Contact No | 9123010236 |
| Address | 12 PITAMBAR DEY LANE | Age | 17 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||