Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06854 | Date 01/09/2022 |
| Token No | SM/22-23/4781 01/09/2022 | Serial | 001 |
| Patient Name | Miss SHIBANI DAS | Contact No | 8100612992 |
| Address | 79 DEY STREET | Age | 18 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||