Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05467 | Date 22/02/2022 |
| Token No | SM/21-22/2239 22/02/2022 | Serial | 011 |
| Patient Name | Miss RITIKA BAG | Contact No | 8273078703 |
| Address | 3 A B GARDEN LANE | Age | 7 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||