Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03469 | Date 22/11/2019 |
| Token No | SM/24-25/20137 11/12/2024 | Serial | 012 |
| Patient Name | Mr. SUVAM KOIRI | Contact No | 7980499087 |
| Address | DEY GHAT LANE | Age | 13 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||