Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 06611 | Date 04/08/2022 |
| Token No | SM/22-23/4294 04/08/2022 | Serial | 008 |
| Patient Name | Mr. SAILA CHANDRA DEY | Contact No | 9339627412 |
| Address | 28 G T ROAD, MADAM BAGAN | Age | 65 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||