Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05894 | Date 23/05/2022 |
| Token No | SM/22-23/3048 23/05/2022 | Serial | 009 |
| Patient Name | Miss SARASWATI DAS.... | Contact No | 9330982165 |
| Address | 80 DEY STREET | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||