Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03690 | Date 06/01/2020 |
| Token No | SM/24-25/20260 18/12/2024 | Serial | 012 |
| Patient Name | Mr. GAGAN SHAW | Contact No | 9007681460 |
| Address | 2 LALIT MOHON BHATTACHARJEE STREET | Age | 17 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||