Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08075 | Date 30/12/2022 |
| Token No | SM/22-23/7283 30/12/2022 | Serial | 013 |
| Patient Name | Mr. UMESH SHA | Contact No | 9038881450 |
| Address | 33 DR. N.L. BHATTACHARYA STREET | Age | 38 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||