Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06159 | Date 20/06/2022 |
| Token No | SM/22-23/3501 20/06/2022 | Serial | 018 |
| Patient Name | Mr. KALIPADA DAS | Contact No | 9007586425 |
| Address | 22 THAKUR BATI STREET | Age | 71 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||