Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06174 | Date 21/06/2022 |
| Token No | SM/22-23/3519 21/06/2022 | Serial | 012 |
| Patient Name | Baby AYUSHI KUMARI SHA | Contact No | 8764825772 |
| Address | 10 DEY STREET | Age | 5 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||