Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 08886 | Date 27/04/2023 |
| Token No | SM/22-23/9203 27/04/2023 | Serial | 006 |
| Patient Name | Mr. DEBAL MAKAL | Contact No | NOT GIVEN |
| Address | 8A BROJO DUTTA LANE | Age | 46 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||