Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03023 | Date 11/09/2019 |
| Token No | SM/21-22/1227 04/10/2021 | Serial | 002 |
| Patient Name | Mr. RAJESWAR MAHATO | Contact No | 8820981483 |
| Address | 14 B DEY STREET | Age | 48 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||