Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04337 | Date 27/04/2021 |
| Token No | SM/22-23/8194 04/03/2023 | Serial | 004 |
| Patient Name | Mr. SUKUMAR ADHIKARY | Contact No | 8100631337 |
| Address | 86 DEY STREET | Age | 31 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||