Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01769 | Date 08/03/2019 |
| Token No | SM/24-25/17986 07/08/2024 | Serial | 029 |
| Patient Name | Mr. RAMASANKAR SHAW | Contact No | 7980464213 |
| Address | 12 RAMSITA LANE | Age | 46 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||