Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04689 | Date 05/08/2021 |
| Token No | SM/21-22/780 05/08/2021 | Serial | 011 |
| Patient Name | Mr. CHANDRESWAR PRASAD DAS | Contact No | NOT GIVEN |
| Address | 100 R B SARANI | Age | 37 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||