Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11410 | Date 15/04/2024 |
| Token No | SM/24-25/15766 15/04/2024 | Serial | 047 |
| Patient Name | Mr. GOPI DAS | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 50 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||