Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08574 | Date 17/03/2023 |
| Token No | SM/22-23/8360 17/03/2023 | Serial | 006 |
| Patient Name | Mr. MODON DAS | Contact No | 9905696264 |
| Address | 26 T C GOSWAMI STREET | Age | 40 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||