Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03971 | Date 21/03/2023 |
| Token No | SM/22-23/7706 21/03/2023 | Serial | 012 |
| Patient Name | Mr. SIDDHARTHA SUTRADHAR | Contact No | 9831813933 |
| Address | GHORAMARA SERAMPORE 712203 | Age | 11 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||