Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12202 | Date 05/10/2024 |
| Token No | SM/24-25/19203 05/10/2024 | Serial | 002 |
| Patient Name | Mr. CHANDI LAL RAY | Contact No | 6205872404 |
| Address | 12/540 RAM SITA LANE | Age | 41 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||