Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04917 | Date 24/09/2021 |
| Token No | SM/21-22/1150 24/09/2021 | Serial | 001 |
| Patient Name | Miss ANJALI SHAW.. | Contact No | 9331903567 |
| Address | INDIA JUTE MILL, 3 NO QUARTER | Age | 12 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||