Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03457 | Date 21/11/2019 |
| Token No | SM/22-23/13634 08/12/2023 | Serial | 008 |
| Patient Name | Miss SANDHYA PRASAD | Contact No | 7278628863 |
| Address | PAL BAGAN, 10 DEY STREET | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||