Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04811 | Date 26/08/2021 |
| Token No | SM/21-22/961 26/08/2021 | Serial | 026 |
| Patient Name | Mr. SAMBHU NATH DAS | Contact No | 9331943290 |
| Address | 22 THAKUR BATI STREET | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||