Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09318 | Date 19/05/2025 |
| Token No | SM/25-26/2242 19/05/2025 | Serial | 050 |
| Patient Name | Mr. SOUMOJIT SEN | Contact No | 9831858622 |
| Address | CHOTO TAJPUR BEGUMPUR 712306 | Age | 10 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||