Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09825 | Date 02/08/2023 |
| Token No | SM/22-23/11300 02/08/2023 | Serial | 003 |
| Patient Name | Miss MADHUSMITA BISWAL | Contact No | 8420489009 |
| Address | 44B/1 DR. N L BHATTACHARJEE STREET | Age | 8 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||