Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02652 | Date 07/09/2022 |
| Token No | SM/22-23/2555 07/09/2022 | Serial | 026 |
| Patient Name | Mr. GOPAL KUMAR VERMA | Contact No | 9903333500 |
| Address | 66/E/1 GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 46 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||