Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04829 | Date 31/08/2021 |
| Token No | SM/24-25/19246 07/10/2024 | Serial | 033 |
| Patient Name | Mr. HEMAGNI DAS | Contact No | 9903126790 |
| Address | 118 G T ROAD | Age | 12 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||