Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 08128 | Date 06/01/2023 |
| Token No | SM/22-23/7399 06/01/2023 | Serial | 014 |
| Patient Name | Mr. ROHIT KUMAR DAS | Contact No | 9123000585 |
| Address | 104 R B SARANI | Age | 21 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||