Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08429 | Date 22/02/2023 |
| Token No | SM/22-23/8027 22/02/2023 | Serial | 016 |
| Patient Name | Miss JYOTI SHAW | Contact No | 8276903631 |
| Address | 82 DEY STREET | Age | 11 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||