Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04830 | Date 31/08/2021 |
| Token No | SM/21-22/989 31/08/2021 | Serial | 011 |
| Patient Name | Miss AMRITA KUMARI | Contact No | 8910661489 |
| Address | 14/C DEY STREET | Age | 2 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||