Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05161 | Date 15/12/2021 |
| Token No | SM/22-23/4668 23/08/2022 | Serial | 021 |
| Patient Name | Mr. SANDIP ROY | Contact No | 8017646532 |
| Address | 56 AKHRABATI LANE | Age | 14 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||