Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06570 | Date 01/08/2022 |
| Token No | SM/22-23/4213 01/08/2022 | Serial | 001 |
| Patient Name | Mr. SURENDRA JAISWARA | Contact No | NOT GIVEN |
| Address | JUBILI BASTI, J.N.LAHIRI ROAD | Age | 46 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||