Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 06473 | Date 25/07/2022 |
| Token No | SM/22-23/4040 25/07/2022 | Serial | 032 |
| Patient Name | Mr. RUDRA SHANKAR NATH | Contact No | NOT GIVEN |
| Address | 121 KUMIRJALA ROAD | Age | 66 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||