Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09008 | Date 11/05/2023 |
| Token No | SM/22-23/9488 11/05/2023 | Serial | 013 |
| Patient Name | Mr. MADAN PANJA | Contact No | NOT GIVEN |
| Address | 10 DOSTI LANE | Age | 66 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||