Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09855 | Date 03/08/2023 |
| Token No | SM/22-23/11352 03/08/2023 | Serial | 016 |
| Patient Name | Mr. ABHIMANYU KUMAR SHAW | Contact No | 9748223225 |
| Address | 6/187 RAM SITA LANE | Age | 17 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||