Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05155 | Date 14/12/2021 |
| Token No | SM/21-22/2152 14/02/2022 | Serial | 010 |
| Patient Name | Miss ARADHYA JKAISWARA | Contact No | 8582904901 |
| Address | 7 DEY GHAT LANE | Age | 5 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||