Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02288 | Date 17/06/2019 |
| Token No | SM/21-22/1775 04/01/2022 | Serial | 012 |
| Patient Name | Mr. DUDHNATH SINGH | Contact No | NOT GIVEN |
| Address | 90/C DEY STREET | Age | 63 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||