Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04965 | Date 04/10/2021 |
| Token No | SM/21-22/1231 04/10/2021 | Serial | 006 |
| Patient Name | Miss SAYANTIKA MALIK.. | Contact No | 7980128858 |
| Address | 11 A B GARDEN LANE | Age | 7 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||