Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 04782 | Date 23/08/2021 |
| Token No | SM/21-22/912 23/08/2021 | Serial | 007 |
| Patient Name | Mr. TANDARA DUTTA | Contact No | NOT GIVEN |
| Address | 71/6 PATUA PARA | Age | 51 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||