Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09001 | Date 11/05/2023 |
| Token No | SM/22-23/9479 11/05/2023 | Serial | 004 |
| Patient Name | Mrs. MONALISA PAL | Contact No | 9121880335 |
| Address | 11 NO LINE, INDIA JUTE MILL | Age | 13 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||