Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04514 | Date 21/06/2021 |
| Token No | SM/21-22/457 21/06/2021 | Serial | 004 |
| Patient Name | Mr. SRIKANTA DEY | Contact No | 6291654454 |
| Address | 53 PANCHANAN TALA LANE | Age | 22 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||