Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05527 | Date 11/03/2022 |
| Token No | SM/21-22/2397 11/03/2022 | Serial | 012 |
| Patient Name | Miss SITAL ROY | Contact No | NOT GIVEN |
| Address | 86 DEY STREET | Age | 3 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||