Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11357 | Date 03/04/2024 |
| Token No | SM/24-25/15577 03/04/2024 | Serial | 003 |
| Patient Name | Mr. BHOLANATH JANA | Contact No | 6290002130 |
| Address | 12 WILLIUM CARREY ROAD | Age | 62 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||