Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02023 | Date 02/05/2019 |
| Token No | SM/22-23/14508 31/01/2024 | Serial | 027 |
| Patient Name | Mr. UMA SANKAR SHAW | Contact No | NOT GIVEN |
| Address | 14B DEY ST | Age | 71 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||