Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05957 | Date 27/05/2022 |
| Token No | SM/22-23/3149 27/05/2022 | Serial | 013 |
| Patient Name | Mr. NANDADULAL KOLE | Contact No | NOT GIVEN |
| Address | 23A/1 PANCHANAN TALA LANE | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||