Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01345 | Date 06/12/2018 |
| Token No | SM/22-23/2645 05/04/2022 | Serial | 010 |
| Patient Name | Mr. GOBINDA PRADHAN | Contact No | NOT GIVEN |
| Address | PITAMBAR DEY LANE | Age | 50 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||