Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02813 | Date 16/08/2019 |
| Token No | SM/24-25/17870 01/08/2024 | Serial | 026 |
| Patient Name | Miss G HARIKA | Contact No | 9331326648 |
| Address | N L BHATTACHARYA STREET | Age | 10 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||