Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05443 | Date 17/02/2022 |
| Token No | SM/21-22/2183 17/02/2022 | Serial | 008 |
| Patient Name | Mr. SAILEN ROY | Contact No | 8478960060 |
| Address | 34B DEY BAGAN | Age | 64 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||