Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05563 | Date 21/03/2022 |
| Token No | SM/21-22/2475 21/03/2022 | Serial | 010 |
| Patient Name | Miss RIYA DAS | Contact No | 8697301808 |
| Address | 11 A B GARDEN LANE | Age | 19 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||