Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03406 | Date 16/11/2019 |
| Token No | SM/22-23/4491 11/08/2022 | Serial | 027 |
| Patient Name | Mr. DHARMNATH SHAW | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 60 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||