Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04788 | Date 23/08/2021 |
| Token No | SM/21-22/1012 31/08/2021 | Serial | 034 |
| Patient Name | Miss AROHI GUPTA | Contact No | NOT GIVEN |
| Address | KAILASH CHATTERJEE LANE | Age | 9 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||