Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05595 | Date 29/03/2022 |
| Token No | SM/21-22/2536 29/03/2022 | Serial | 010 |
| Patient Name | Mr. ROHIT KUMAR ROY | Contact No | NOT GIVEN |
| Address | 26 A K C BHATTACHARJEE STREET | Age | 5 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||