Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03375 | Date 14/11/2019 |
| Token No | SM/22-23/9007 21/04/2023 | Serial | 027 |
| Patient Name | Miss RIYA BISWAL | Contact No | 6291877649 |
| Address | 14B DEY STREET | Age | 7 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||