Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06656 | Date 08/08/2022 |
| Token No | SM/22-23/4384 08/08/2022 | Serial | 010 |
| Patient Name | Miss ISHITA RAM | Contact No | NOT GIVEN |
| Address | 7 DEY GHAT LANE | Age | 8 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||