Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02089 | Date 20/05/2019 |
| Token No | SM/21-22/1582 08/12/2021 | Serial | 011 |
| Patient Name | Mr. SANKAR RAM | Contact No | 7998083904 |
| Address | 2 GOPAL GANGULY LANE | Age | 55 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||