Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04668 | Date 28/07/2021 |
| Token No | SM/21-22/1547 02/12/2021 | Serial | 001 |
| Patient Name | Miss SAYANTIKA MALIK | Contact No | NOT GIVEN |
| Address | 11 A B GARDEN LANE | Age | 9 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||