Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05334 | Date 21/01/2022 |
| Token No | SM/21-22/1967 21/01/2022 | Serial | 002 |
| Patient Name | Mr. NILKANTA CHANDA | Contact No | 9433820805 |
| Address | 82 N N COLONY | Age | 68 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||