Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07904 | Date 07/12/2022 |
| Token No | SM/22-23/6862 07/12/2022 | Serial | 008 |
| Patient Name | Miss ANGEL KOIRI | Contact No | 7980499087 |
| Address | DEY GHAT LANE | Age | 5 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||