Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13237 | Date 16/07/2025 |
| Token No | SM/25-26/1237 16/07/2025 | Serial | 007 |
| Patient Name | Miss DIPANNITA ROY | Contact No | 8620059754 |
| Address | 162 G.T. ROAD, DEY BAGAN | Age | 7 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||