Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07997 | Date 21/12/2022 |
| Token No | SM/22-23/7092 21/12/2022 | Serial | 013 |
| Patient Name | Miss SAHANA SUBLA | Contact No | 8100245199 |
| Address | 5/B/3/1 DEY STREET | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||