Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04591 | Date 13/07/2021 |
| Token No | SM/21-22/1381 12/11/2021 | Serial | 006 |
| Patient Name | Mr. SUNIL DAS | Contact No | 8697318195 |
| Address | 57/A PATUA PARA LANE | Age | 58 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||