Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10305 | Date 05/09/2023 |
| Token No | SM/24-25/18222 16/08/2024 | Serial | 025 |
| Patient Name | Miss ROSHNI DOM | Contact No | 7449792838 |
| Address | NEAR SMASAN KALI | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||