Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07079 | Date 19/09/2022 |
| Token No | SM/22-23/5186 19/09/2022 | Serial | 005 |
| Patient Name | Mr. ANKIT ROY | Contact No | 8961693177 |
| Address | 56 AKHRA BATI LANE | Age | 14 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||