Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04499 | Date 15/06/2021 |
| Token No | SM/21-22/432 15/06/2021 | Serial | 002 |
| Patient Name | Mr. SANJIV MEHROTRA | Contact No | 7003304980 |
| Address | CHOWDHURY PARA | Age | 56 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||