Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10615 | Date 03/10/2023 |
| Token No | SM/25-26/1365 24/07/2025 | Serial | 004 |
| Patient Name | Baby NISHA KUMARI | Contact No | 8777638645 |
| Address | 4 DEY GHAT LANE | Age | 8 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||