Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04021 | Date 14/09/2020 |
| Token No | SM/22-23/5943 01/11/2022 | Serial | 035 |
| Patient Name | Mr. BHOLANATH DEY | Contact No | NOT GIVEN |
| Address | A B GARDEN LANE | Age | 82 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||