Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10574 | Date 28/09/2023 |
| Token No | SM/22-23/13114 01/11/2023 | Serial | 001 |
| Patient Name | Mr. SHIBAM RAM | Contact No | 8910360960 |
| Address | 7 DEY GHAT LANE | Age | 12 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||