Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03428 | Date 19/11/2019 |
| Token No | SM/24-25/18800 17/09/2024 | Serial | 006 |
| Patient Name | Master BHIM ROY | Contact No | 9123750538 |
| Address | DEY STREET | Age | 11 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||