Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05880 | Date 19/05/2022 |
| Token No | SM/22-23/3680 29/06/2022 | Serial | 008 |
| Patient Name | Mr. NIMAI BAIRAGI | Contact No | NOT GIVEN |
| Address | 46/A POTUA PARA LANE | Age | 80 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||