Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 05184 | Date 20/09/2023 |
| Token No | SM/22-23/13380 22/09/2023 | Serial | 001 |
| Patient Name | Mr. PRABHAT KUMAR SHAW | Contact No | 6290037187 |
| Address | 138 SUBHASNAGAR KARLMARX SARANI RISHRA 712250 | Age | 46 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||