Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 02018 | Date 23/06/2022 |
| Token No | SM/22-23/880 27/06/2022 | Serial | 014 |
| Patient Name | Mr. RAMA SHANKAR SINGH | Contact No | 8420423195 |
| Address | 690 S K NAGAR RISHRA M PRABASHNAGAR SERAMPORE 712249 | Age | 64 Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||