Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04975 | Date 22/10/2021 |
| Token No | SM/21-22/1255 22/10/2021 | Serial | 001 |
| Patient Name | Mr. LALIT DUTTA | Contact No | 9088355700 |
| Address | 71A/6 PTUA PARA LANE | Age | 69 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||