Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04522 | Date 23/06/2021 |
| Token No | SM/22-23/14219 10/01/2024 | Serial | 034 |
| Patient Name | Mr. MANOJ RAM | Contact No | NOT GIVEN |
| Address | 2 GOPAL GANGULY LANE | Age | 17 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||