Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04973 | Date 07/10/2021 |
| Token No | SM/21-22/1244 07/10/2021 | Serial | 001 |
| Patient Name | Mr. HARU DAS | Contact No | 8014184390 |
| Address | MANIKTALA G.T.ROAD | Age | 72 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||