Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05428 | Date 14/02/2022 |
| Token No | SM/21-22/2154 14/02/2022 | Serial | 012 |
| Patient Name | Mr. ABDUL HAI MANDAL | Contact No | 7980414470 |
| Address | 55 DEY STREET | Age | 49 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||