Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07392 | Date 25/10/2022 |
| Token No | SM/22-23/9184 26/04/2023 | Serial | 014 |
| Patient Name | Miss GANGA BARIK | Contact No | 8777349469 |
| Address | 19 DOSTI LANE | Age | 16 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||