Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11487 | Date 09/05/2024 |
| Token No | SM/25-26/1097 07/07/2025 | Serial | 001 |
| Patient Name | Miss SUBHOSRI PRADHAN | Contact No | 8902208656 |
| Address | 2 PANCHANANTALA LANE | Age | 11 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||