Ticket for Outdoor Patient
| Ward No. 22 | U-PHC No. | Registration No. 05402 | Date 08/02/2022 |
| Token No | SM/21-22/2111 08/02/2022 | Serial | 012 |
| Patient Name | Mr. RINA SHARMA | Contact No | 9330202045 |
| Address | GANGULY BAGAN, MAHESH | Age | 30 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||