Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01666 | Date 25/05/2022 |
| Token No | SM/22-23/106 25/05/2022 | Serial | 018 |
| Patient Name | Mrs. TIYA MISTRI | Contact No | |
| Address | KATAPOL SERAMPORE | Age | 4 YEAR 7 MONTH Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||