Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 10643 | Date 04/10/2023 |
| Token No | SM/22-23/12940 04/10/2023 | Serial | 019 |
| Patient Name | Master PRAMOD DAS | Contact No | 8017853207 |
| Address | 85 J.N. LAHIRI ROAD | Age | 4 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||