Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07198 | Date 11/10/2022 |
| Token No | SM/22-23/5416 11/10/2022 | Serial | 016 |
| Patient Name | Miss SHILPA BAG | Contact No | NOT GIVEN |
| Address | 4 A.B. GARDEN LANE | Age | 4 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||