Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09215 | Date 02/06/2023 |
| Token No | SM/22-23/10884 14/07/2023 | Serial | 004 |
| Patient Name | Mr. GOURANGA PRADHAN | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL 9 NO LINE | Age | 57 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||