Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05114 | Date 26/11/2021 |
| Token No | SM/21-22/1517 26/11/2021 | Serial | 004 |
| Patient Name | Mr. PRABIR MAKAL | Contact No | 9051817851 |
| Address | 8 BROJO DUTTA LANE | Age | 53 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||