Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04882 | Date 07/09/2021 |
| Token No | SM/22-23/8858 11/04/2023 | Serial | 024 |
| Patient Name | Mr. SANKAR DAS | Contact No | NOT GIVEN |
| Address | 132 PATUA PARA | Age | 64 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||