Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04831 | Date 31/08/2021 |
| Token No | SM/24-25/15931 23/04/2024 | Serial | 017 |
| Patient Name | Mr. PIRBHUBAN SINGH | Contact No | 8910661489 |
| Address | 14/C DEY STREET | Age | 63 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||