Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01730 | Date 27/05/2022 |
| Token No | SM/22-23/194 27/05/2022 | Serial | 055 |
| Patient Name | Mrs. MANIKA MAJHI | Contact No | |
| Address | MALLICKPARA SERAMPORE 712203 | Age | 8 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||