Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05164 | Date 17/12/2021 |
| Token No | SM/21-22/1659 17/12/2021 | Serial | 004 |
| Patient Name | Mr. BHASKAR PRADAHAN | Contact No | NOT GIVEN |
| Address | 9 NO LINE, INDIA JUTE MILL | Age | 71 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||