Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10202 | Date 29/08/2023 |
| Token No | SM/22-23/12078 29/08/2023 | Serial | 011 |
| Patient Name | Mr. NIMAI MODAK | Contact No | |
| Address | PACHU BAZAR | Age | 75 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||