Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10706 | Date 01/11/2023 |
| Token No | SM/22-23/13120 01/11/2023 | Serial | 007 |
| Patient Name | Mr. SAGAR KUMAR SHA | Contact No | 7439067572 |
| Address | RAM SITA LANE, NAYA BAGAN | Age | 6 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||