Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06242 | Date 28/06/2022 |
| Token No | SM/22-23/3650 28/06/2022 | Serial | 027 |
| Patient Name | Master PRINCE SEN | Contact No | NOT GIVEN |
| Address | BANDEL | Age | 12 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||