Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10570 | Date 28/09/2023 |
| Token No | SM/22-23/12792 28/09/2023 | Serial | 023 |
| Patient Name | Miss TANU RAJBHAR | Contact No | 7003258734 |
| Address | 10 DEY STREET | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||