Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05645 | Date 04/04/2022 |
| Token No | SM/22-23/2613 04/04/2022 | Serial | 019 |
| Patient Name | Master SOHOM DAS | Contact No | NOT GIVEN |
| Address | 529 G T ROAD | Age | 1 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||