Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02182 | Date 04/06/2019 |
| Token No | SM/22-23/8384 17/03/2023 | Serial | 030 |
| Patient Name | Master AYUSH KUMAR SHAW | Contact No | 9038101860 |
| Address | RAMSITA LANE NAYA BAGAN | Age | 5 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||