Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03236 | Date 19/10/2019 |
| Token No | SM/24-25/18375 24/08/2024 | Serial | 015 |
| Patient Name | Mr. NIMAI SHRIMANI | Contact No | NOT GIVEN |
| Address | 25A DEY ST | Age | 70 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||