Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 05999 | Date 03/06/2022 |
| Token No | SM/22-23/4955 07/09/2022 | Serial | 003 |
| Patient Name | Mr. LALIT KUMAR DUTTA | Contact No | 9088355700 |
| Address | 71A/6 POTUA PARA LANE | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||