Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05536 | Date 15/03/2022 |
| Token No | SM/21-22/2424 15/03/2022 | Serial | 002 |
| Patient Name | Mr. SUMIT KHATIK | Contact No | 6289953443 |
| Address | 79 DEY STREET | Age | 15 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||