Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04372 | Date 10/05/2021 |
| Token No | SM/21-22/241 10/05/2021 | Serial | 003 |
| Patient Name | Mr. SWAPAN DASGUPTA | Contact No | 8334052232 |
| Address | 10 DEY BAGAN LANE | Age | 51 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||