Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07991 | Date 21/12/2022 |
| Token No | SM/22-23/7081 21/12/2022 | Serial | 002 |
| Patient Name | Mr. RUPNARAYAN RAJBHAE | Contact No | NOT GIVEN |
| Address | 10 DEY STREET | Age | 62 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||