Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09681 | Date 19/07/2023 |
| Token No | SM/22-23/11011 19/07/2023 | Serial | 002 |
| Patient Name | Miss DIPTI PAL | Contact No | 9088974671 |
| Address | 44/1/E DR. N L B STREET | Age | 13 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||