Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02049 | Date 10/05/2019 |
| Token No | SM/22-23/7112 22/12/2022 | Serial | 006 |
| Patient Name | Miss AYUSHI ROY | Contact No | 7044008574 |
| Address | 6 DEY GHAT LANE | Age | 12 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||