Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04363 | Date 06/05/2021 |
| Token No | SM/21-22/228 06/05/2021 | Serial | 006 |
| Patient Name | Mr. SHIB KUMAR DAS | Contact No | NOT GIVEN |
| Address | 122 R.B SARANI | Age | 62 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||