Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02069 | Date 16/05/2019 |
| Token No | SM/21-22/476 23/06/2021 | Serial | 006 |
| Patient Name | Miss SAKSHI KUMARI | Contact No | 8199931294 |
| Address | 6 RAMSITA LANE NAYA BAGAN | Age | 2 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||