Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06494 | Date 26/07/2022 |
| Token No | SM/22-23/4075 26/07/2022 | Serial | 025 |
| Patient Name | Miss JHUM PAKIRA | Contact No | 7008952102 |
| Address | A B GARDEN LANE | Age | 5 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||