Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 10318 | Date 07/09/2023 |
| Token No | SM/22-23/12308 07/09/2023 | Serial | 001 |
| Patient Name | Miss RAI ROY | Contact No | 9331806715 |
| Address | 16L SITAL SARKAR LANE | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||