Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 01632 | Date 08/02/2019 |
| Token No | SM/22-23/13940 20/12/2023 | Serial | 017 |
| Patient Name | Master ADITYA DEY | Contact No | 7044629112 |
| Address | 45/1 JITEN LAHIRI ROAD | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||