Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09095 | Date 18/05/2023 |
| Token No | SM/22-23/9641 18/05/2023 | Serial | 001 |
| Patient Name | Mr. DIP DAS | Contact No | 7596835821 |
| Address | BANERJEE PARA | Age | 14 Male |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||