Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05099 | Date 25/11/2021 |
| Token No | SM/21-22/1496 25/11/2021 | Serial | 006 |
| Patient Name | Miss ANWESHA SEN | Contact No | 9831371769 |
| Address | THAKUR BATI STREET | Age | 16 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||