Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06517 | Date 27/07/2022 |
| Token No | SM/22-23/11900 23/08/2023 | Serial | 022 |
| Patient Name | Miss BRISTI KOLEY.. | Contact No | NOT GIVEN |
| Address | POTUA PARA | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||