Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07364 | Date 21/10/2022 |
| Token No | SM/22-23/11305 02/08/2023 | Serial | 008 |
| Patient Name | Mr. NIRAJ KUMAR ROY | Contact No | 9330801433 |
| Address | 180 RAM SITA LANE | Age | 18 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||