Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05254 | Date 07/01/2022 |
| Token No | SM/21-22/1831 07/01/2022 | Serial | 012 |
| Patient Name | Mr. KANAI LAL DAS | Contact No | 8697583983 |
| Address | 70C PATUA PARA | Age | 65 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||