Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07906 | Date 07/12/2022 |
| Token No | SM/22-23/6865 07/12/2022 | Serial | 011 |
| Patient Name | Miss DIPTI PAL | Contact No | 8777787965 |
| Address | 44/1/E N.L. BHATTACHARYA STREET | Age | 14 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||