Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07950 | Date 15/12/2022 |
| Token No | SM/22-23/7005 15/12/2022 | Serial | 014 |
| Patient Name | Master ROMI DAS | Contact No | NOT GIVEN |
| Address | THAKURBATI STREET | Age | 1yr 10 months Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||