Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04658 | Date 26/07/2021 |
| Token No | SM/22-23/14141 08/01/2024 | Serial | 005 |
| Patient Name | Mr. SUNANDA SEN | Contact No | 6289943051 |
| Address | 10 RUDRARAM PANDIT LANE | Age | 56 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||