Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04629 | Date 19/07/2021 |
| Token No | SM/21-22/665 19/07/2021 | Serial | 008 |
| Patient Name | Mr. NIKHILESH DUTTA | Contact No | 8820637993 |
| Address | 54 G T ROAD, KALITALA | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||