Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04862 | Date 18/08/2023 |
| Token No | SM/22-23/12052 19/08/2023 | Serial | 022 |
| Patient Name | Mr. JIT MONDAL | Contact No | 8116594933 |
| Address | AHIRAN BASANTAPUR AJAGARPARA 742223 | Age | 17 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||