Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04589 | Date 13/07/2021 |
| Token No | SM/21-22/588 13/07/2021 | Serial | 003 |
| Patient Name | Mr. ADITYA SHAH | Contact No | 7890953937 |
| Address | 40 N L BHATTACHARJEE STREET | Age | 19 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||