Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05383 | Date 02/02/2022 |
| Token No | SM/21-22/2083 02/02/2022 | Serial | 009 |
| Patient Name | Mr. SHAKTI BAG | Contact No | NOT GIVEN |
| Address | BHAGIRATHI LANE | Age | 50 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||