Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07805 | Date 25/11/2022 |
| Token No | SM/22-23/6631 25/11/2022 | Serial | 010 |
| Patient Name | Miss KALPANA MALLICK | Contact No | 9339931688 |
| Address | 12 PITAMBAR DEY LANE | Age | 11 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||