Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11399 | Date 13/04/2024 |
| Token No | SM/24-25/15711 13/04/2024 | Serial | 002 |
| Patient Name | Miss SONAMONI HAZRA,., | Contact No | 9147064445 |
| Address | NEAR MADAN MOHAN TEMPLE | Age | 9 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||