Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05945 | Date 26/05/2022 |
| Token No | SM/22-23/4605 18/08/2022 | Serial | 015 |
| Patient Name | Mr. MADAN MOHAN BHAR | Contact No | 8420798588 |
| Address | 41 RISHI BANKIM SARANI | Age | 58 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||