Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01294 | Date 22/11/2018 |
| Token No | SM/24-25/16349 17/05/2024 | Serial | 019 |
| Patient Name | Mr. JAY PRAKASH RAY | Contact No | 8013280906 |
| Address | 180 QUATER, RAM SITA LANE | Age | 47 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||