Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 04881 | Date 07/09/2021 |
| Token No | SM/24-25/18990 25/09/2024 | Serial | 004 |
| Patient Name | Mr. SUBOL CHANDRA DAS | Contact No | NOT GIVEN |
| Address | 51/1 B P 2ND LANE | Age | 64 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||