Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01169 | Date 13/03/2020 |
| Token No | SM/25-26/2161 17/05/2025 | Serial | 011 |
| Patient Name | Mr. SURAJ DAS | Contact No | 7890489650 |
| Address | GHORAMARA P MALLICKPARA 712203 | Age | 16 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||