Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05380 | Date 02/02/2022 |
| Token No | SM/21-22/2080 02/02/2022 | Serial | 006 |
| Patient Name | Miss DIPANNITA PAKIRA | Contact No | 9674288264 |
| Address | CHOWDHUY PARA | Age | 10 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||