Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10178 | Date 28/08/2023 |
| Token No | SM/22-23/12044 28/08/2023 | Serial | 046 |
| Patient Name | Mr. SUSIL SARKEL | Contact No | 8420099249 |
| Address | 42 NO THAKURBATI STREET | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||