Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13336 | Date 05/08/2025 |
| Token No | SM/25-26/1536 05/08/2025 | Serial | 010 |
| Patient Name | Mr. SUDHAKAR PRADHAN | Contact No | 9038660080 |
| Address | 45 DR. N.L. BHATTACHARYA STREET | Age | 7 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||