Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05523 | Date 11/03/2022 |
| Token No | SM/21-22/2389 11/03/2022 | Serial | 004 |
| Patient Name | Miss SURABHI DAS | Contact No | 9163899748 |
| Address | 7 DEY GHAT LANE | Age | 12 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||