Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05555 | Date 17/03/2022 |
| Token No | SM/22-23/12643 25/09/2023 | Serial | 004 |
| Patient Name | Miss MEGHA RAJBHAR | Contact No | 9748377653 |
| Address | 17 DEY STREET | Age | 12 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||