Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04312 | Date 21/04/2021 |
| Token No | SM/21-22/2398 11/03/2022 | Serial | 013 |
| Patient Name | Mr. SUNITI DEY | Contact No | 8017284391 |
| Address | 4/D DEY STREET | Age | 66 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||