Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07666 | Date 15/11/2022 |
| Token No | SM/22-23/6320 15/11/2022 | Serial | 007 |
| Patient Name | Mr. AJAY KUMAR SHAW | Contact No | 8961582297 |
| Address | 13 NO LINE | Age | 58 Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||