Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 04342 | Date 28/04/2021 |
| Token No | SM/21-22/186 28/04/2021 | Serial | 004 |
| Patient Name | Mr. SIBNATH DEY | Contact No | 9836518176 |
| Address | 8 GOALA PARA | Age | 46 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||