Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08973 | Date 04/05/2023 |
| Token No | SM/22-23/9392 04/05/2023 | Serial | 012 |
| Patient Name | Mr. DINANATH SHA | Contact No | 9062375128 |
| Address | 30 DR. N L BHATTACHARYA STREET | Age | 46 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||