Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05592 | Date 29/03/2022 |
| Token No | SM/21-22/2529 29/03/2022 | Serial | 003 |
| Patient Name | Mr. RINA DEY | Contact No | 6289549337 |
| Address | 5B/2 GOPAL GANGULY LANE | Age | 49 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||