Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02891 | Date 26/08/2019 |
| Token No | SM/22-23/14047 03/01/2024 | Serial | 004 |
| Patient Name | Mr. BHISHAN CHAND DEY | Contact No | NOT GIVEN |
| Address | 1 DEY STREET | Age | 78 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||