Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 11920 | Date 08/08/2024 |
| Token No | SM/24-25/18021 08/08/2024 | Serial | 012 |
| Patient Name | Miss TUHI DAS | Contact No | 8961123173 |
| Address | 159 DEY BAGAN MANIKTALA | Age | 11 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||