Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 04803 | Date 26/08/2021 |
| Token No | SM/21-22/946 26/08/2021 | Serial | 011 |
| Patient Name | Mr. ARUN BOSE | Contact No | 9163083358 |
| Address | 290/A G T ROAD | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||