Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05653 | Date 04/04/2022 |
| Token No | SM/22-23/2621 04/04/2022 | Serial | 027 |
| Patient Name | Master TRITANU DHARA | Contact No | NOT GIVEN |
| Address | 37 NABAKRISHNA GUIN LANE | Age | 5 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||