Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05472 | Date 24/02/2022 |
| Token No | SM/22-23/4634 22/08/2022 | Serial | 022 |
| Patient Name | Mrs. BABY RAM | Contact No | 6290395529 |
| Address | 7 DEY GHAT LANE | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||