Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09868 | Date 04/08/2023 |
| Token No | SM/22-23/11386 04/08/2023 | Serial | 014 |
| Patient Name | Miss NARMADA PRADHAN | Contact No | 7890056714 |
| Address | 12 PITAMBAR DEY LANE | Age | 9 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||