Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04710 | Date 12/08/2021 |
| Token No | SM/21-22/816 12/08/2021 | Serial | 001 |
| Patient Name | Mr. JOYDIP NATH | Contact No | 6290950935 |
| Address | 8 DOSTY LANE | Age | 4 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||