Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07809 | Date 03/09/2024 |
| Token No | SM/25-26/15436 02/03/2026 | Serial | 012 |
| Patient Name | Mr. DIPTO HALDER | Contact No | 7890520295 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 14 Years,2 Months,30 Days Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||