Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09101 | Date 18/05/2023 |
| Token No | SM/22-23/9655 18/05/2023 | Serial | 015 |
| Patient Name | Mr. PRITHHISH DEY | Contact No | 7009856980 |
| Address | 79 DEY STREET | Age | 35 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||