Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09721 | Date 21/07/2023 |
| Token No | SM/22-23/11100 21/07/2023 | Serial | 003 |
| Patient Name | Mr. SUBHAM SHAW | Contact No | 9903873822 |
| Address | 10 DEY STREET | Age | 13 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||