Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01329 | Date 04/12/2018 |
| Token No | SM/21-22/1114 13/09/2021 | Serial | 003 |
| Patient Name | Mr. NAWAL ROY | Contact No | 8013280906 |
| Address | INDIA JUTE MILL | Age | 32 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||