Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06123 | Date 17/06/2022 |
| Token No | SM/24-25/16344 17/05/2024 | Serial | 014 |
| Patient Name | Miss JIA DUTTA | Contact No | 9051211884 |
| Address | 80A/3 DEY STREET, PAL BAGAN | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||