Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05657 | Date 14/11/2023 |
| Token No | SM/22-23/16829 22/12/2023 | Serial | 017 |
| Patient Name | Miss SNEHA DAS | Contact No | 8158829947 |
| Address | BELGACHHI SOMRA 712123 | Age | 13 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||