Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10160 | Date 28/08/2023 |
| Token No | SM/22-23/12010 28/08/2023 | Serial | 012 |
| Patient Name | Mr. SUNIL MAJHI | Contact No | 7890643577 |
| Address | 18 NO LINE DHARMATALA | Age | 35 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||