Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04225 | Date 26/05/2023 |
| Token No | SM/22-23/9096 26/05/2023 | Serial | 018 |
| Patient Name | Mr. RIPON DEWAN | Contact No | 7001908912 |
| Address | AMBIKA KALNA | Age | 35 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||