Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08168 | Date 17/01/2023 |
| Token No | SM/22-23/7515 17/01/2023 | Serial | 020 |
| Patient Name | Miss SANJITA DAS | Contact No | 9330982165 |
| Address | PAL BAGAN | Age | 3 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||