Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 06551 | Date 29/07/2022 |
| Token No | SM/22-23/7858 13/02/2023 | Serial | 024 |
| Patient Name | Miss SAMPURNA SHARMA | Contact No | 9123988255 |
| Address | 29 SHIBTALA LANE | Age | 11 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||