Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01726 | Date 28/02/2019 |
| Token No | SM/21-22/1750 03/01/2022 | Serial | 006 |
| Patient Name | Miss DIPIKA PRASAD | Contact No | 9883670314 |
| Address | 3 DEY GHAT LANE | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||