Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04212 | Date 23/05/2023 |
| Token No | SM/22-23/9047 23/05/2023 | Serial | 007 |
| Patient Name | Mr. MUNNA GOPE | Contact No | |
| Address | 168 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 45 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||