Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 05279 | Date 11/01/2022 |
| Token No | SM/21-22/1864 11/01/2022 | Serial | 011 |
| Patient Name | Mr. NIRMAL KUMAR ADAK | Contact No | 6291643757 |
| Address | 420/6 G.T.ROAD | Age | 87 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||