Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01929 | Date 18/04/2019 |
| Token No | SM/25-26/2750 25/11/2025 | Serial | 003 |
| Patient Name | Mr. ABHIJIT DEY | Contact No | 8013632287 |
| Address | 89/C DEY ST | Age | 51 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||