Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11853 | Date 29/07/2024 |
| Token No | SM/24-25/17784 29/07/2024 | Serial | 011 |
| Patient Name | Mr. DEB KUMAR SHA | Contact No | 9903591004 |
| Address | 7/274 RAM SITA LANE | Age | 45 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||