Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04807 | Date 26/08/2021 |
| Token No | SM/22-23/14279 16/01/2024 | Serial | 008 |
| Patient Name | Mr. RAJESWAR MAHATO | Contact No | NOT GIVEN |
| Address | 19 DOSTI LANE | Age | 46 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||