Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05556 | Date 17/03/2022 |
| Token No | SM/21-22/2458 17/03/2022 | Serial | 004 |
| Patient Name | Mr. JITEN DAS.. | Contact No | 9432982164 |
| Address | 12 PITAMBAR DEY LANE | Age | 37 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||