Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11038 | Date 17/01/2024 |
| Token No | SM/22-23/14283 17/01/2024 | Serial | 003 |
| Patient Name | Mr. KRISHNA DAS | Contact No | 6290203278 |
| Address | CHOTOBELU CHJECK POST | Age | 19 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||