Ticket for Outdoor Patient
| Ward No. 7 | U-PHC No. | Registration No. 06197 | Date 23/06/2022 |
| Token No | SM/22-23/3562 23/06/2022 | Serial | 009 |
| Patient Name | Mr. GOUR HARI DAS | Contact No | NOT GIVEN |
| Address | 102 N.S AVENUE | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||