Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05506 | Date 08/03/2022 |
| Token No | SM/21-22/2351 08/03/2022 | Serial | 017 |
| Patient Name | Miss SARASWATI DAS.. | Contact No | NOT GIVEN |
| Address | 80 DEY STREET | Age | 9 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||