Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 08720 | Date 06/04/2023 |
| Token No | SM/22-23/8759 06/04/2023 | Serial | 012 |
| Patient Name | Mr. SUBHA BARIK | Contact No | 8334005809 |
| Address | 530B G.T. ROAD | Age | 15 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||