Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03214 | Date 18/10/2019 |
| Token No | SM/22-23/8478 22/03/2023 | Serial | 025 |
| Patient Name | Baby DEEP RAM | Contact No | NOT GIVEN |
| Address | 4 DEY GHAT LANE | Age | 4YR 3MONTHS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||