Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 05420 | Date 14/02/2022 |
| Token No | SM/21-22/2143 14/02/2022 | Serial | 001 |
| Patient Name | Mr. GOPAL DEY | Contact No | 9007758495 |
| Address | 34 K M SHA STREET | Age | 63 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||