Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03113 | Date 24/09/2019 |
| Token No | SM/22-23/15158 11/03/2024 | Serial | 009 |
| Patient Name | Mr. DEB KUMAR DAS | Contact No | NOT GIVEN |
| Address | 10 DOSTI LANE | Age | 11 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||