Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05091 | Date 24/11/2021 |
| Token No | SM/21-22/1475 24/11/2021 | Serial | 024 |
| Patient Name | Mr. ANANDA SHAW | Contact No | 9163899748 |
| Address | 83 DEY STREET | Age | 41 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||