Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06628 | Date 04/08/2022 |
| Token No | SM/22-23/4322 04/08/2022 | Serial | 036 |
| Patient Name | Baby ANKITA HELA | Contact No | NOT GIVEN |
| Address | PAL BAGAN | Age | 1.5 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||