Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11610 | Date 05/06/2024 |
| Token No | SM/25-26/3081 22/12/2025 | Serial | 019 |
| Patient Name | Master RUDRA RAJBHAR | Contact No | 8777521443 |
| Address | 10 DEY STREET | Age | 2 YRS 2 MONTHS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||