Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09764 | Date 25/07/2023 |
| Token No | SM/24-25/18897 21/09/2024 | Serial | 001 |
| Patient Name | Mr. CHANDAN SHA | Contact No | 7890044628 |
| Address | 80/A/2 DEY STREET | Age | 28 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||