Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05778 | Date 05/05/2022 |
| Token No | SM/22-23/2863 05/05/2022 | Serial | 002 |
| Patient Name | Miss RITTIKA SHAW | Contact No | 7438962518 |
| Address | 2 L M BHATTACHARJEE STREET | Age | 13 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||