Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09559 | Date 06/07/2023 |
| Token No | SM/22-23/10800 12/07/2023 | Serial | 006 |
| Patient Name | Miss PIYA ROY | Contact No | 9875336312 |
| Address | N L BHATTACHARJEE STREET | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||