Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 10196 | Date 29/08/2023 |
| Token No | SM/22-23/12072 29/08/2023 | Serial | 005 |
| Patient Name | Master SANDIP BAYEN | Contact No | 8617799311 |
| Address | CHATRA, GODAR BAGAN BYE LANE | Age | 15 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||