Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05737 | Date 21/04/2022 |
| Token No | SM/22-23/2782 21/04/2022 | Serial | 006 |
| Patient Name | Mr. ANANDA KUMAR SHAW | Contact No | 9163899748 |
| Address | 83 DEY STREET | Age | 36 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||