Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07171 | Date 10/10/2022 |
| Token No | SM/24-25/18908 21/09/2024 | Serial | 012 |
| Patient Name | Mr. BHOMBOL DAS | Contact No | 9062376072 |
| Address | PANCHANAN TALA LANE | Age | 51 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||