Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08083 | Date 02/01/2023 |
| Token No | SM/22-23/7305 02/01/2023 | Serial | 004 |
| Patient Name | Mr. BIJAY KUMAR ROY | Contact No | 9432834042 |
| Address | RAM SITA LANE | Age | 48 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||