Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04889 | Date 07/09/2021 |
| Token No | SM/21-22/1087 07/09/2021 | Serial | 015 |
| Patient Name | Mr. AMIT SHA | Contact No | 9470761692 |
| Address | BAT TALA | Age | 23 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||