Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07582 | Date 10/11/2022 |
| Token No | SM/22-23/6162 10/11/2022 | Serial | 006 |
| Patient Name | Miss PRAGYATRI CHAKRABORTY | Contact No | 7290036119 |
| Address | 76 DEY STREET | Age | 14 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||