Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04334 | Date 26/04/2021 |
| Token No | SM/21-22/173 26/04/2021 | Serial | 012 |
| Patient Name | Baby JOSHUA DAS | Contact No | 8420995667 |
| Address | 7 WILLAM CAREY ROAD | Age | 5 MONTHS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||