Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10558 | Date 28/09/2023 |
| Token No | SM/22-23/12774 28/09/2023 | Serial | 005 |
| Patient Name | Mr. SHIVAM KUMAR ROY | Contact No | 9711716321 |
| Address | 7/343 COCKRAIN ROAD | Age | 13 YRS Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||