Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06219 | Date 27/06/2022 |
| Token No | SM/22-23/3615 27/06/2022 | Serial | 011 |
| Patient Name | Miss MANISHA SINGH | Contact No | 8910636234 |
| Address | 23 DR N.L BHATTACHARYA ST | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||