Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05721 | Date 20/04/2022 |
| Token No | SM/22-23/2751 20/04/2022 | Serial | 005 |
| Patient Name | Baby PRACHI ROY | Contact No | 9875551578 |
| Address | 86 DEY STREET | Age | 2 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||