Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05476 | Date 28/02/2022 |
| Token No | SM/21-22/2278 28/02/2022 | Serial | 003 |
| Patient Name | Miss AMRITA NATH | Contact No | 6291424322 |
| Address | 185 N N COLONY | Age | 4 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||