Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12736 | Date 06/03/2025 |
| Token No | SM/25-26/1198 14/07/2025 | Serial | 002 |
| Patient Name | Baby SRISTI KUMARI | Contact No | 8334073908 |
| Address | 4 DEY GHAT LANE | Age | 2 months Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||