Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05137 | Date 07/12/2021 |
| Token No | SM/21-22/1571 07/12/2021 | Serial | 013 |
| Patient Name | Mr. ANURIT ROY | Contact No | 9875650744 |
| Address | 90 PATUA PARA | Age | 12 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||