Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08282 | Date 07/02/2023 |
| Token No | SM/22-23/7738 07/02/2023 | Serial | 033 |
| Patient Name | Mr. K.K. DE | Contact No | 9339961617 |
| Address | 76 DEY STREET | Age | 74 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||