Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07698 | Date 16/11/2022 |
| Token No | SM/22-23/10305 17/06/2023 | Serial | 001 |
| Patient Name | Mr. RAJKUMAR SHA | Contact No | NOT GIVEN |
| Address | 79 DEY STREET | Age | 50 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||