Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04207 | Date 30/03/2021 |
| Token No | SM/20-21/9220 30/03/2021 | Serial | 008 |
| Patient Name | Miss PRIYANKA SONI | Contact No | NOT GIVEN |
| Address | 12 PITAMBAR DEY LANE | Age | 7 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||