Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 11665 | Date 15/06/2024 |
| Token No | SM/24-25/16915 15/06/2024 | Serial | 010 |
| Patient Name | Mr. BIRU SHAW | Contact No | 9088586388 |
| Address | 43 BHAGIRATHI LANE | Age | 13 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||