Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04849 | Date 01/09/2021 |
| Token No | SM/22-23/14715 09/02/2024 | Serial | 004 |
| Patient Name | Mr. JITEN DAS | Contact No | 9432982164 |
| Address | 12 PITAMBAR DEY LANE | Age | 38 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||