Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08124 | Date 29/10/2024 |
| Token No | SM/24-25/32234 04/12/2024 | Serial | 031 |
| Patient Name | Mr. CHAYAN DAS | Contact No | 8910531976 |
| Address | GHORAMARA MALLICKPARA 712203 | Age | 16 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||