Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03381 | Date 14/11/2019 |
| Token No | SM/24-25/18105 09/08/2024 | Serial | 044 |
| Patient Name | Mr. KANHAIYA SHA | Contact No | 8910037619 |
| Address | 6 RAM SITA LANE NAYA BAGAN | Age | 29 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||