Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04421 | Date 01/06/2021 |
| Token No | SM/22-23/8012 22/02/2023 | Serial | 001 |
| Patient Name | Miss PUTUL KUMARI | Contact No | 6290849750 |
| Address | 5 B DEY STREET | Age | 7 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||