Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03705 | Date 07/01/2020 |
| Token No | SM/24-25/20434 10/01/2025 | Serial | 010 |
| Patient Name | Miss SONIA RAJBHAR | Contact No | 8019520025 |
| Address | DEY GHAT LANE | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 39 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||