Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12912 | Date 23/04/2025 |
| Token No | SM/25-26/209 23/04/2025 | Serial | 020 |
| Patient Name | Master PIYUSH DAS | Contact No | 7890060545 |
| Address | 104 JAILKHANA LANE | Age | 11 months Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||