Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01619 | Date 05/02/2019 |
| Token No | SM/21-22/2100 08/02/2022 | Serial | 001 |
| Patient Name | Miss SAYANTIKA MALIK | Contact No | 7981028858 |
| Address | 11A A B GARDEN LANE | Age | 10 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||