Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00029 | Date 07/09/2019 |
| Token No | SM/19-20/290 23/09/2019 | Serial | 009 |
| Patient Name | Mr. SHAMBHU ADHIKARY | Contact No | 9903415793 |
| Address | CHAKLAPARA,PRABASHNAGAR 712249 | Age | 62 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||