Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13200 | Date 03/07/2025 |
| Token No | SM/25-26/1086 03/07/2025 | Serial | 011 |
| Patient Name | Miss JIYANA PRADHAN | Contact No | 9875446955 |
| Address | 8/416 RAM SITA LANE | Age | 13 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||