Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13183 | Date 30/06/2025 |
| Token No | SM/25-26/1028 30/06/2025 | Serial | 013 |
| Patient Name | Miss AMRITA KUMARI | Contact No | 9801435934 |
| Address | 14C DEY STREET | Age | 5 yr 6 months Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||