Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06414 | Date 20/07/2022 |
| Token No | SM/22-23/3940 20/07/2022 | Serial | 024 |
| Patient Name | Mr. SOUMEN DOLUI | Contact No | 9674870140 |
| Address | KALITALA | Age | 46 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||