Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05413 | Date 10/02/2022 |
| Token No | SM/21-22/2130 10/02/2022 | Serial | 010 |
| Patient Name | Mr. BAIDYANATH DAS | Contact No | 9883242514 |
| Address | 15 G T ROAD, KALITALA | Age | 36 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||