Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04471 | Date 11/06/2021 |
| Token No | SM/21-22/400 11/06/2021 | Serial | 003 |
| Patient Name | Mr. DEBASISH DEY | Contact No | 6290027689 |
| Address | 4 G.T. ROAD | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||