Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09057 | Date 15/05/2023 |
| Token No | SM/22-23/9575 15/05/2023 | Serial | 028 |
| Patient Name | Mr. PULAK RAJBHAR | Contact No | NOT GIVEN |
| Address | 10 DEY STREET | Age | 67 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||