Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12041 | Date 31/08/2024 |
| Token No | SM/24-25/18518 31/08/2024 | Serial | 015 |
| Patient Name | Mr. D.P. SHAW | Contact No | 6289865960 |
| Address | RAM SITA LANE | Age | 69 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||