Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05723 | Date 20/04/2022 |
| Token No | SM/22-23/2753 20/04/2022 | Serial | 007 |
| Patient Name | Miss ANANYA GUPTA | Contact No | 9330138922 |
| Address | 5/A RAJMOHAN GOSWAMI LANE | Age | 15 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||