Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 07137 | Date 26/09/2022 |
| Token No | SM/22-23/5318 26/09/2022 | Serial | 015 |
| Patient Name | Master NALLA SHIVAN | Contact No | 8013734489 |
| Address | 77C/2 J N LAHIRI ROAD | Age | 7 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||