Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03874 | Date 05/03/2020 |
| Token No | SM/22-23/3455 17/06/2022 | Serial | 003 |
| Patient Name | Mr. BHIM SEN DAS | Contact No | 9883172955 |
| Address | 12 PITAMBAR DEY LANE | Age | 49 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||