Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05580 | Date 23/03/2022 |
| Token No | SM/21-22/2509 23/03/2022 | Serial | 007 |
| Patient Name | Mr. PRAVAT APAT | Contact No | 9830547972 |
| Address | 44B/5 N L BHATTACHARJEE STREET | Age | 9 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||