Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06553 | Date 29/07/2022 |
| Token No | SM/22-23/4185 29/07/2022 | Serial | 014 |
| Patient Name | Mr. SUKANTA HALDER | Contact No | 8798458710 |
| Address | KALITALA | Age | 33 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||