Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01931 | Date 18/04/2019 |
| Token No | SM/24-25/17987 07/08/2024 | Serial | 030 |
| Patient Name | Mr. SALENDAR ROY | Contact No | 8013280906 |
| Address | RAM SITA LANE | Age | 25 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||