Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05939 | Date 26/05/2022 |
| Token No | SM/24-25/19623 08/11/2024 | Serial | 014 |
| Patient Name | Mr. MOLOY SAMANTA | Contact No | NOT GIVEN |
| Address | 27 K. C. LANE | Age | 76 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||