Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10048 | Date 21/08/2023 |
| Token No | SM/22-23/11791 21/08/2023 | Serial | 026 |
| Patient Name | Mr. RAJA RAM KHATIK.. | Contact No | 8420766607 |
| Address | 9 NO LINE INDIA JUTE MILL | Age | 70 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||