Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08262 | Date 06/02/2023 |
| Token No | SM/22-23/7696 06/02/2023 | Serial | 011 |
| Patient Name | Miss PAMELA ROY | Contact No | NOT GIVEN |
| Address | 22 P K B LANE | Age | 12 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||